Could the tube strike lead to better population health?
Edmund Stubbs, 6 August 2015
Albania suffered under a harsh communist dictatorship from the end of the Second World War to the beginning of the 1990s. Personal freedom was limited during this period. Very few people were permitted to own cars and access to public transport was likewise limited. As a consequence, people were often forced to make their daily journeys by other means.
For demographers who try to draw conclusions detached from political or ethical criteria in order to understand general principles, the case of Albania offers an interesting insight into how a population, forced by necessity to undertake most of their travel under their own volition, fares.
One such demographer, Arjan Gjonca of LSE has evidenced that the citizens in Albania had, during that epoch, extremely good health compared to that of their neighbours, with especially low levels of cardiovascular disease. Although this was probably also due to dietary factors, the fact that citizens were forced to take regular exercise in their daily journeys was a contributory factor.
Although in no way likening the hardship faced in communist Albania to any situation we encounter today in Britain (especially to a trivial tube strike) and without suggesting that living under such a regime would be in any way preferable, Albania illustrates, on a demographic basis, the positive effect that routine exercise can have on population health.
Today, once again one of London’s vital organs: its circulatory system, has ground to a halt. Many of those with after-work plans for this evening will now no doubt choose to go home instead, desperately trying find a means that does not involve London’s atrophied underground network. The strike has created a sizeable problem for those living especially far from the centre who must navigate their way using multiple crowded buses and over ground trains in order get to and from work. Not a pleasant experience.
However, for some living slightly closer to the centre, coping with the tube strike might act as inspiration, demonstrating how exercise can be incorporated into a daily routine. Instead of getting the tube, as most would have normally done this morning, a large number of Londoners decided to put on their trainers, shorts and a backpack and either to walk, cycle or run to work, thereby avoiding overcrowded buses and multiple changes.
As I walked to work today, I noticed the empty, Santander-sponsored ‘Boris bike’ racks near my zone 2 flat and the full ones near my Westminster office; a clear sign that many more than usual were using these bicycles for their daily commute. I also noticed markedly more cyclists, joggers and walkers sharing my route.
The NHS, as is well known, is struggling to keep up with the demand for its services. As a result, health care policy makers are recognising the importance of improving general population health in order to reduce pressure on the service. As an example, Professor Chris Ham of the King’s Fund has identified measures to improve population health as one of the most exciting possibilities that might arise from Greater Manchester’s devolved healthcare plans.
In London, for one and a half days only, commuters have no alternative other than to re-assess their route to work and perhaps use their own muscle power to get themselves from A to B. It is to be hoped that some might have found this experience at street level rather than beneath it, a pleasant experience, and one they might wish to repeat in the future.
Every person who incorporates more exercise into their daily routine represents one less potential case of diabetes, and will be less prone to future disability cased by obesity or cardiovascular disease. If society can reduce its level of sedentary activity it will result in healthier, happier lives for individuals while at the same time assuring the future of our threatened NHS. A win win situation if ever there was one.
Edmund Stubbs is Healthcare Researcher at Civitas, @edmundstubbs1