Cycling to health in Northern Ireland

Dr Mark Tully makes the case for cycling investment as a public health intervention in Northern Ireland, to tackle both physical and mental health problems.

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It’s election season and political parties are setting out their vision for the future of Northern Ireland. Cycling investment is no longer an issue on the margins of mainstream policy, but is beginning to be embedded into area planning, new urban developments and government policies.

The Bicycle Strategy for Northern Ireland sets a bold 25 year vision for creating the conditions for cycling to be an attractive option for both leisure and transport. Underpinning all moves to get more people on bicycles is the notion of a potentially massive benefit to public health:

“Implementation of the Bicycle Strategy has the potential to play a significant part in achieving national health policies. The health benefits of increased levels of cycling are numerous and include a fitter, healthier society, improved mental health, lower levels of obesity and fewer sick days from work.”

So it’s worth taking a closer look at those “numerous” benefits in this critical period when cycling investment levels will be determined for the next five years.


Dr Mark Tully of the UKCRC Centre of Excellence for Public Health at Queen’s University Belfast makes the case for cycling investment as a public health intervention in Northern Ireland, to tackle both physical and mental health problems.

Since the ground-breaking discoveries by Jerry Morris in the 1950s that demonstrated the relationship between physical activity and cardiovascular risk [1], our understanding of the importance of engaging in regular physical activity for health has been clearly shown.

Physical inactivity contributes to over 20 common chronic conditions including heart disease, diabetes, some cancers and mental ill health, and accounts for over five million of the 57 million deaths that occurred worldwide in 2008 [2].

The current levels of physical inactivity in the UK are estimated to cost the NHS £1.8bn per year in treating related diseases, and up to £8bn to the UK economy, through the additional societal costs [3].


Current recommendations state that every adult should gain at least 150 minutes of moderate intensity physical activity per week. However despite over half a century of attempts to tackle this problem, levels of inactivity remain high, with estimates that approximately 60% of UK adults are inactive [4].

Addressing low levels of physical inactivity is a major public health challenge that requires new approaches, including addressing the environmental determinants of physical activity [5].

Promoting active travel (such as cycling to work) has received considerable interest recently, due to its potential to be an activity that can become an automatic process, integrated into daily life (such as travel to work) as opposed to a recreational activity that may place an extra burden to maintain long term [6].


Those who engage in regular active travel as part of their journey to work report significantly higher levels of total physical activity [7, 8]. For example, a recent review which included information from 187,000 people concluded that regular cycling (equivalent to meeting current recommended level of activity) leads to 10% reduction in the risk of death from all causes.

They identified that the greatest benefits were experienced by those who moved from doing no cycling, to doing some every week, reinforcing the importance of providing high quality infrastructure to encourage people who don’t cycle to take to their wheels.


Other recent observational research has demonstrated that active travel is associated with an 11% reduction in cardiovascular risk [9] and significant reductions in body fat [10]. In addition, Martin et al [11] has shown that switching from car travel to active travel is associated with significant improvements in mental well-being.

Are you a politician looking to save money to the health service, improve the lives of our population and put a smile on everyone’s face… how could you not invest in cycling?

MTully1Dr Mark Tully (@marktully_qub) is a researcher and lecturer in the UKCRC Centre of Excellence for Public Health (NI) at the School of Medicine, Dentistry and Biomedical Sciences at Queen’s University Belfast.
His research focuses on addressing population levels of physical inactivity, which is a major cause of death and disease, including cardiovascular disease, cancer and diabetes.
He is also a 2013 Fréd Award winner for QUB’s work to support the Reclaim Belfast’s Cycle Lanes project.

  1. Morris, J.N., et al., Coronary heart-disease and physical activity of work. Lancet, 1953. 265(6796): p. 1111-20; concl.
  2. Lee, I.M., et al., Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet, 2012. 380(9838): p. 219-29.
  3. Allender, S., et al., The burden of physical activity-related ill health in the UK. Journal of Epidemiology and Community Health, 2007. 61(4): p. 344-348.
  4. Hallal, P.C., et al., Global physical activity levels: surveillance progress, pitfalls, and prospects. Lancet, 2012. 380(9838): p. 247-57.
  5. Hallal, P.C., et al., Physical activity: more of the same is not enough. Lancet, 2012. 380(9838): p. 190-91.
  6. Saunders, L.E., et al., What are the health benefits of active travel? A systematic review of trials and cohort studies. PLoS One, 2013. 8(8): p. e69912.
  7. Yang, L., et al., Associations between active commuting and physical activity in working adults: cross-sectional results from the Commuting and Health in Cambridge study. Prev Med, 2012. 55(5): p. 453-7.
  8. Sahlqvist, S., Y. Song, and D. Ogilvie, Is active travel associated with greater physical activity? The contribution of commuting and non-commuting active travel to total physical activity in adults. Prev Med, 2012. 55(3): p. 206-11.
  9. Hamer, M. and Y. Chida, Active commuting and cardiovascular risk: a meta-analytic review. Prev Med, 2008. 46(1): p. 9-13.
  10. Flint, E. and S. Cummins, Active commuting and obesity in mid-life: cross-sectional, observational evidence from UK Biobank. The Lancet Diabetes & Endocrinology, 2016.
  11. Martin, A., Y. Goryakin, and M. Suhrcke, Does active commuting improve psychological wellbeing? Longitudinal evidence from eighteen waves of the British Household Panel Survey. Prev Med, 2014. 69: p. 296-303.

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