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Cycling your commute can lower risk of death by 47%, as long as you aren't hit by a driver

Researchers conclude findings "reinforce need for safer cycling infrastructure", as people who commute by bike enjoy physical and mental health benefits, but have "twice the risk of being a road traffic casualty compared with non-active commuters"...

Research published in the British Medical Journal concluded that its findings "provide direct evidence of the health benefits of active commuting", with those who cycle to work associated with a 47 per cent lower risk of death and 24 per cent lower risk of hospital admission for cardiovascular disease. However, with cycle commuters twice as likely as 'inactive' commuters to be admitted to hospital after a road traffic collision, the research suggests it "reinforces the need for safer cycling infrastructure" to enable more people to access active travel journeys and the "important" health benefits.

The researchers analysed data from the Scottish Longitudinal Study, which is based on five per cent of the Scottish population and taken from census returns in 1991, 2001 and 2011. After excluding incomplete data, a sample of 82,297 people aged between 16-74 years old in 2001 who travelled to work or study in the UK was analysed.

Cyclist LTN planter, Hackney London (by Adwitiya Pal)

Having accounted for potentially influential factors, the researchers found that active commuting was associated with lower risks of death and mental and physical ill health, compared with 'inactive' commuting. For cyclists specifically, a lower risk of death of 47 per cent was cited, along with a 10 per cent lower risk of any hospital admission, and a 24 per cent lower risk of hospital admission for cardiovascular disease.

Cycle commuters were also associated with a 30 per cent lower risk of being prescribed a drug to treat cardiovascular disease, a 51 per cent lower risk of dying from cancer, a 24 per cent lower risk of being admitted to hospital because of cancer, and a 20 per cent lower risk of being prescribed drugs for mental health problems.

> New research finds commuting by bike can improve mental health, with those who cycle to work less likely to be prescribed antidepressants

The researchers concluded the findings "strengthen the evidence that active commuting has population-level health benefits and can contribute to reduced morbidity and mortality", but stressed it also "reinforces the need for safer cycling infrastructure".

This is because, they note, commuters who cycle their journeys to work or study were twice as likely to be admitted to hospital following a road traffic collision than 'inactive' commuters.

For pedestrians, there was an 11 per cent lower risk of hospital admission for any cause, a 10 per cent lower risk of a hospital admission for cardiovascular disease, a 10 per cent lower risk of being prescribed drugs to treat cardiovascular disease, and a seven per cent lower risk of being prescribed drugs for mental health issues.

As it was an observational study, the researchers were quick to point out no firm conclusions can be drawn about causal factors, and accepted that there would be limitations to the research, such as the fact census data reflects one point in time and did not include general physical activity levels. Similarly, prescription data was only available from 2009 onwards.

Cyclist using cycle lane in Edinburgh (Cycling Scotland)

However, the researchers concluded: "This study strengthens the evidence that active commuting has population-level health benefits and can contribute to reduced morbidity and mortality. That cyclist and pedestrian commuting is associated with lower risks of being prescribed medication for poor mental health is an important finding. 

"These findings provide direct evidence of the health benefits of active commuting in a Scottish context, supporting current policy. This study has wider global relevance to efforts to reduce carbon emissions and to shift to more active and sustainable travel modes.

> British cyclists feel less safe and more dissatisfied with their cycle lanes compared to European riders, research finds

"Our finding that cyclist commuters have twice the risk of being a road traffic casualty compared with non-active commuters reinforces the need for safer cycling infrastructure."

Researchers came to their conclusions by linking census data for 82,000 people with national hospital admissions and prescription data. Cycling and walking were classed as 'active' commuting, while all other forms were defined as 'inactive'. Where multiple modes of transport were used, the mode used for the longest part by distance was applied.

Age, sex, pre-existing health conditions, socioeconomic factors, and distance to work/study were taken into consideration, the researchers noting that cycle commuters were more likely to be men, younger, shift workers, live in a city, and less likely to be homeowners or carers.

Cyclist using cycle lane in Edinburgh (Cycling Scotland)

Of the 82,297 people considered, 4,276 died between 2001 and 2018. Almost half (2,023) died of cancer, while 52,804 were admitted to hospital, 9,663 for cardiovascular disease, 5,939 for cancer, and 2,668 following a road traffic collision.

More than a third of the total participants were prescribed a drug associated with cardiovascular disease between 2009 and 2018, while 41 per cent (33,771) were prescribed a drug for poor mental health.

While the cycle commuters tended to be male, compared with inactive commuters those who walked to work/study were more likely to be female, younger, work shifts, commute shorter distances, live in a city, and less likely to have dependent children.

Dan is the road.cc news editor and joined in 2020 having previously written about nearly every other sport under the sun for the Express, and the weird and wonderful world of non-league football for The Non-League Paper. Dan has been at road.cc for four years and mainly writes news and tech articles as well as the occasional feature. He has hopefully kept you entertained on the live blog too.

Never fast enough to take things on the bike too seriously, when he's not working you'll find him exploring the south of England by two wheels at a leisurely weekend pace, or enjoying his favourite Scottish roads when visiting family. Sometimes he'll even load up the bags and ride up the whole way, he's a bit strange like that.

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29 comments

Avatar
polainm | 5 months ago
1 like

Drivers don't care, period. It's a mental illness and addiction. We could have photos of people dying from terrible obesigenic disorders on cars, like cigarette packets, but it wouldn't do anything.  

Just revel in that lean physique and watch how more and more people can barely walk more than 500m from their car. 

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ktache | 5 months ago
3 likes

From the specific definitions in this study I count as an inactive commuter, there goes my health benefits...

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eburtthebike | 5 months ago
5 likes

While I welcome the additional evidence that regular cyclists live longer and are less likely to suffer from all forms of illness, none of the previous studies seem to have changed government policy.  Well, they've changed the wording I suppose, and announced significant investment into cycling, then withdrew most of it: hopefully labour might just do some "evidence based policy making".  Like everyone else hasn't.

But then there's this, which is misleading, confusing and likely to discourage anyone from taking up cycle commuting:

....those who cycle to work associated with a 47 per cent lower risk of death and 24 per cent lower risk of hospital admission for cardiovascular disease. However, with cycle commuters twice as likely as 'inactive' commuters to be admitted to hospital after a road traffic collision....

How is anyone supposed to do a realistic risk assessment based on that?  Unless the risks are expressed to a common base, there is no way to compare them, and the effect is to exaggerate the risk of RTCs and diminish the beneficial effects.  AIUI, the beneficial effects massively outweigh the negatives, but you'd never know from that statement.

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Deeferdonk | 5 months ago
0 likes

Surely being fit and healthy, is a bigger cause of cycling to work, than cycling to work is of being fit and healthy.

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mitsky replied to Deeferdonk | 5 months ago
7 likes

I would argue against that and it might depend on the definition of "fit and healthy".

I am definitely not an athlete by anyone's standards but at a low pace can cycle for miles.

As long as a person is able to cycle and long distances or other conditions like hills weren't an issue then most people can do it.

I've seen an adult with what may be Parkinsons cycle at low speed on an adult tricycle.
No idea how far he goes but if he isn't put off by his low speed against normal motor traffic...

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chrisonabike replied to mitsky | 5 months ago
2 likes

Well... in the UK it's still mostly the fit and the brave cycling because of various barriers and negative feedback.  And (if they think about either group at all) people tend to see "cyclists" and "people with specific mobility requirements" as two different groups - probably in conflict.

That could possibly be changed though - we know that by looking at other places.

There are some ideas for the UK here:

https://wheelsforwellbeing.org.uk/

I've seen anecdata which suggests that people with Parkinson's disease can actually cycle quite well even if their walking gait is affected.

Then there's:

https://www.nature.com/articles/s41531-021-00222-6

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levestane | 5 months ago
1 like

Headline needs context

" ... we selected 82 297 individuals aged 16–74 years. Individuals were followed-up between 2001 and 2018 ..."

Never believe headlines (or take-away messages).

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mitsky | 5 months ago
4 likes

Does this mean being a cycling commuter that we have a 47% chance of IMMORTALITY...?

Surely that would be headline news around the world, if it was true.

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chrisonabike replied to mitsky | 5 months ago
4 likes

Correct - the trick is to stop cycling and bank your eternal status before you collect the other prize of "high chance of serious injury or death" when in collision with a motor vehicle.

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anotherflat | 5 months ago
0 likes

The link to the paper on the BMJ website seems to be broken unfortunately. So can't clarify the RTC hospital comment, but on Eurekaalert in one paragraph it says that "cyclist commuters were twice as likely as ‘inactive’ commuters to be admitted to hospital after a road traffic collision" and in another it says that "cyclist commuters have twice the risk of being a road traffic casualty". Which are not the same thing.
I'd say that following a reportable RTC (because presumably that's the info they have?) only having twice the likelihood of hospitalisation as a motor vehicle occupant is a good result for cyclists.

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OnYerBike replied to anotherflat | 5 months ago
1 like

The link seems to be working for me. I've only skimmed it quickly, but my understanding is:

Participants were classified as "cycle commuters" or not based on what box they ticked on the Census.

People who were classified as "cycle commuters" were twice as likely to have a RTC-related hospital admission over the study period than the average study participant. (There is no requirement that the person was riding their bike, let alone riding to work, at the time of the RTC).

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Miller | 5 months ago
2 likes

Let me know when the risk of death is lowered by 100%

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chrisonabike replied to Miller | 5 months ago
3 likes

Remarkable still - I thought the risk of death *was* 100%...

(Given you're born a human, usual caveats for the biological and philosophical pedants apply...)

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hawkinspeter replied to chrisonabike | 5 months ago
4 likes

chrisonabike wrote:

Remarkable still - I thought the risk of death *was* 100%...

(Given you're born a human, usual caveats for the biological and philosophical pedants apply...)

If you look at how many humans have ever lived, then only about 93% of them have died

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chrisonabike replied to hawkinspeter | 5 months ago
3 likes

hawkinspeter wrote:

chrisonabike wrote:

Remarkable still - I thought the risk of death *was* 100%...

(Given you're born a human, usual caveats for the biological and philosophical pedants apply...)

If you look at how many humans have ever lived, then only about 93% of them have died

Most of them haven't died on my watch though, so I'm speculating... (I also think that population statistic is pretty wild)

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mitsky replied to chrisonabike | 5 months ago
4 likes

I was wondering about the bad wording too... laugh

As Tyler Durden/The Narrator said...
"On a long enough timeline, the survival rate for everyone drops to zero."

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anagallis_arvensis | 5 months ago
0 likes

Based on the text the title of this article is a pretty disgraceful misrepresentation of the article. If road.cc journalists can't do this better how can we expect others to get it right

"For cyclists specifically, a lower risk of death of 47 per cent was cited, along with a 10 per cent lower risk of any hospital admission, "

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mdavidford replied to anagallis_arvensis | 5 months ago
3 likes

I'm not sure why you'd expect non-specialist editors to be any better at 'getting it right' than anybody else. It's a bike website - science communication and statistical literacy aren't exactly in the core competencies.

Besides which, you might need to expand on what your criticism actually is. There are multiple issues with the way the headline interprets the results of the study, but simply pasting that quote there doesn't really illuminate any of them.

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wtjs replied to mdavidford | 5 months ago
3 likes

I agree- the criticism is too harsh- and I have no doubt that the niceties in the BMJ article would be difficult to get across. It's the bit about being hit by drivers that concerns me! I know that there's no deterrence, as the police will simply write the incident off as 'insufficient evidence' and 'just one of those things'

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anagallis_arvensis replied to mdavidford | 5 months ago
0 likes
mdavidford wrote:

I'm not sure why you'd expect non-specialist editors to be any better at 'getting it right' than anybody else. It's a bike website - science communication and statistical literacy aren't exactly in the core competencies.

Besides which, you might need to expand on what your criticism actually is. There are multiple issues with the way the headline interprets the results of the study, but simply pasting that quote there doesn't really illuminate any of them.

Because the headline is alarmist bullshit which will put people off doing something that can drastically improve their health and reduce their chances of going to hospital.

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mdavidford replied to anagallis_arvensis | 5 months ago
4 likes

It doesn't come across that way to me. It's primarily reporting what sounds like a very good thing, albeit with a caveat.

It's wrong for a number of reasons, but if anything I would say the net result of that wrongness probably overstates the likely benefits suggested by the study.

In one way, it does undersell it - as far as I can understand it, the 47% figure is including your chances of being hit by a driver - without people going round driving into us it would be even higher. However that's likely more than offset by the overstatement of the claim that it's all down to the choice of commute, which the study doesn't support.

(And that's leaving aside that, as others have noted, claims of 'reducing your chances of death' without any further qualification are just silly.)

All that said, road.cc have basically just followed the lead of the BMJ press release, which contains similar implications (albeit while then trying to fudge their way out of it later on). If you're concerned about misrepresentation, your complaints would probably be more reasonably addressed to them. After all, they're a scientific institution, rather than a cycling website, so there might be more expectation on them to 'get it right'.

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anagallis_arvensis replied to mdavidford | 5 months ago
0 likes

I haven't read the bmj article just this one and given what the article said the headline is just plain wrong. No if no buts just wrong.

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mdavidford replied to anagallis_arvensis | 5 months ago
3 likes

Well, we agree that it's wrong, then. But it is just wrong - it doesn't warrant being called 'disgraceful' or 'alarmist bullshit'.

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FionaJJ replied to anagallis_arvensis | 5 months ago
4 likes

It's interesting that we interpret things different ways. For me I saw it as stating the health benefits of cycling, and making the case that better (safer) cycling infrastructure is required to fully realise the health benefits for more of the population.

 

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anagallis_arvensis replied to FionaJJ | 5 months ago
0 likes

True, but we are not the ones that need convincing, if I were to send that article to a non cycling friend they would read the second part of the headline, conclude cycling is dangerous and resolve not to cycle.

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brooksby | 5 months ago
1 like

Quote:

as long as you aren't hit by a driver

Well, that's the real trick, ain't it? 

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mdavidford | 5 months ago
6 likes

Given that my commute is up to the top of our stairs, I suspect attempting to cycle it would significantly increase my risk of death.

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chrisonabike replied to mdavidford | 5 months ago
4 likes

Do you wear a "stair cycling" helmet though...?

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FionaJJ | 5 months ago
4 likes

Let's hope this study is seen by those working in health, public transport AND the treasury of the new government.

I'm sure I read something about the new government looking for policies that would reduce the burden on the NHS to reduce future costs, but it might have been wishful thinking on my part and it was actually lobby groups hoping to make that case. Regardless, there is a new government and at the very least they are wanting to present the image of being open to ideas on this sort of thing. 

The problem is that governments are prone to thinking short-term, and it's harder to action something where the benefits are not visible before the next election. The government of the day needs to believe that enough voters understand the long-term benefits, so I hope these findings are reported widely.

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