2024-04-02 10:19:51
In the 10 billion euro economy plan recently announced by the government, the first item affected is that of ecology, development and sustainable mobility, with 2.2 billion euros of payment credits canceled. Health seems at first glance relatively spared, with 70 million euros of cancellations – less than 1% of the total. However, cutting state funding targeting sustainable mobility will also contribute to deteriorating public health, in addition to increasing greenhouse gas emissions.
In a recent study, we evaluated the benefits for public health and the climate of cycling in France. Here’s what we learned.
The French cycle little
Our work consisted of analyzing data from the “Mobility of people” survey. This ten-year public survey conducted by INSEE aims to describe people’s mobility practices and to assess how and why the French travel, on a daily basis as well as for their longer distance trips. The 2019 vintage of the survey is based on a nationally representative sample of nearly 14,000 people interviewed in 2018-2019.
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First results of this analysis: the French cycle little. On average for those aged 18 and over, just over 2 km per week. For comparison, Dutch people aged 75 and over cover an average of 13.7km per week, almost 7 times more.
In addition, in France, men cover almost three quarters of the kilometers traveled by bicycle, whereas the practice is much more balanced between the sexes in the Netherlands.
The health benefits of cycling in 2019
Secondly, we quantified the cases of chronic diseases and deaths avoided by the levels of cycling in 2019. To do this, we used the quantitative health impact assessment method, which makes it possible to calculate the extent of the health consequences of exposure to a risk factor, or on the contrary the extent of the health benefits of a protective factor, within a given population.
In the case of cycling, the summary of epidemiological studies on the subject tells us that 100 minutes of cycling per week reduces all-cause mortality by 10% in adults. This relationship between cycling time and mortality risk can then be extrapolated and applied to observed levels of cycling.
In the same way, we selected 5 chronic pathologies for which an association with physical activity had been reported in meta-analyses: cardiovascular diseases, type 2 diabetes, breast cancer, cancer of the prostate and dementia.
We were able to demonstrate that, if the levels of cycling reported in 2019 were kept constant, and although these levels were modest, they already made it possible to avoid nearly 2,000 deaths and 6,000 cases of chronic pathologies each year. .
Chronic diseases and mortality avoided by physical activity due to cycling in France, 2019, among adults aged 20 to 89 years. The black lines represent the 95% uncertainty intervals.
Significant costs avoided
These avoided deaths and chronic pathologies also represent less health spending for the community. The direct medical costs that cycling helps to avoid (hospitalizations, medical treatments, daily allowances) can be quantified using health insurance data: they amount to nearly 200 million euros each year.
However, if these direct medical costs have the advantage of being “tangible”, in the sense that they are monetary expenses, they represent only the tip of the iceberg: avoiding a pathology or a death has a value for society, even in the absence of treatment or compensation. Indeed, illnesses and deaths have intangible consequences which affect not only the person concerned, but also those around them and the community: moral damage, loss of well-being, impact on the lives of loved ones (especially caregivers), loss of productivity, etc.
To take this into account and consistently evaluate the costs of avoided pathologies and deaths, health economists generally use the notion of “intangible health costs”, in other words social health costs.
Based on this notion of intangible health costs, in France, the report of the commission chaired by the economist Émile Quinet recommended in 2013 to use for the evaluation of public policies the value of 3 million euros per deaths avoided, or 3.48 million in current euros.
For our part, we thus estimated that cycling had made it possible to avoid 4.8 billion euros in social health costs in 2019. Compared to the number of kilometers traveled by bike in the year of the survey (4 .6 billion km), this allowed us to estimate that each kilometer traveled by bike helps avoid around 1 euro in social health costs.
What are the consequences of shifting short trips to cycling?
If our analysis provides information on the current health benefits of cycling, it can also tell us more regarding the benefits to be expected from policies to promote cycling.
This is particularly relevant in the French context, since there is significant potential for the development of cycling mobility. In fact, in our country, more than half of journeys of less than 5 km are made by car.
Here, detailed individual data from the Personal Mobility survey make it possible to model the scenario according to which a portion of journeys of less than 5 km made by car would be made by bicycle. In our study, we simulated the effects of a 25% shift from the car to the bicycle for such journeys. Our results indicate that this postponement, quite modest, would make it possible to prevent 1,800 more deaths and avoid an additional 2.6 billion euros in social health costs.
For comparison, the deaths avoided by road safety policies over the last 10 years would have prevented around 1,500 deaths per year.
Finally, this simulation allowed us to estimate that such a modal shift scenario would reduce CO2 emissions by 250 kilotons per year. This corresponds more or less to double the emissions avoided by the tax credits granted for the thermal renovation of housing which had been implemented in 2015 and 2016.
A potential that remains to be exploited
Despite long-standing scientifically documented benefits, it is distressing to note that cycling has not benefited from significant investments, at least over the decade 2010-2019.
As a result, between the 2008 and 2019 Personal Mobility surveys, the proportion of journeys made by bicycle has not increased: it has stagnated at around 3%. However, local authorities often present investments in cycling infrastructure from a cost perspective. However, in addition to our study, which reveals the extent of the benefits that can be expected in terms of health, numerous other studies now document the advantages of cycling in an urban context.
It can therefore be a valuable ally in reducing air pollution and travel times. Promoting bicycle mobility is also a way of reducing the role of the automobile in the city, the harmful effects of which on health are often underestimated.
Furthermore, most energy-climate scenarios compatible with France’s climate commitments, whether developed by ADEME or the négaWatt association, foresee a significant increase in the use of bicycles. In such a context, public authorities would have everything to gain from highlighting the convergence of the climate and health benefits of cycling.
We have shown in other studies that the implementation of the low-carbon transition scenario described in 2021 by the négaWatt association would make it possible to avoid around 10,000 deaths per year by 2050, which would translate into around 40 billion euros in annual profit. Conversely, achieving carbon neutrality by relying primarily on the electrification of the vehicle fleet would completely miss the health benefits linked to physical activity linked to active transport.
This would represent a huge missed opportunity to mobilize this possible synergy between climate change mitigation and improvement of public health.
This article was co-written by Émilie Schwarz, scientific project manager within the Investigation unit of the “Processing and data analysis support” Directorate of Public Health France.
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