Health impacts of active commuting

Active commuting, defined as walking or cycling to/from work, is increasingly recognised as an impactful way to enhance population health and reduce the economic burden of inactivity-related diseases. The economic benefits accrue on the population level to society as a whole, but also to individual workplaces.

Reduced cardiovascular disease, cancer and diabetes risk, reduced sick days, increased mental health. The science is clear that physical activity through active commuting can have significant benefits.

If active commuting were in the form of a pill, everyone would buy it.

Physical Health Benefits

51% lower risk of cancer mortality (HR 0.49, 95% CI 0.30 to 0.82). (Friel et al, 2024)

The benefits of active commuting are primarily benefits from increased physical activity. Through this, active commuting has been shown to significantly reduce the risk of several non-communicable diseases (NCDs). This includes:

• Cardiovascular Disease (CVD): Cycling reduces the risk of CVD by approximately 30%, with greater benefits observed among regular cyclists engaging in higher intensity or longer-duration cycling​ (Celis Moralis et al, 2017)

• Type 2 Diabetes: Several studies show a significant reduction in diabetes risk (up 40%) for individuals engaging in at least 150 minutes of active commuting weekly (e.g. Rasmussen et al, 2016 and references in Mueller et al 2020)

• Cancer Prevention: Cycle commuting has shown to result in a 51 % reduction in cancer mortality (Friel et al, 2024). Reduction in colon cancer by 23-27 % with regular physical activity (Wang et al, 2019), and reduction in breast cancer by 9 % (Pizot et al, 2016)

• Premature Mortality: WHO's Health Economic Assessment Tool (HEAT) indicates that regular walking or cycling can reduce premature mortality rates by 11%, as reviewed in studies across Europe (Rojas-Rueda et al., 2016)​. A recent study from Scotland shows the reduction of all-cause mortality risk with active commuting as high as 47 % (Friel et al 2024).

  
  

Benefits for the workplace

Cyclists have, on average, 1.3 fewer sick days per year compared to non-cyclists. (Decisio, 2017)

Active commuting also yields direct benefits for employers by reducing absenteeism and improving productivity:

• Reduced Sick Days: According to a Dutch review (Decisio, 2017), employees who cycle to work take an average of 1.3 fewer sick days per year compared to non-cyclists. For an organization with 1,000 employees, this equates to saving 1,300 workdays annually, with potential economic savings of €312,000 (assuming €240/day in costs per absent employee).

• Productivity Gains: A study published in the Journal of Occupational and Environmental Medicine found that higher levels of physical activity were associated with improved quality of work performed and overall job performance. Additionally, higher cardiorespiratory fitness was linked to increased quantity of work performed and reduced extra effort exerted to perform work tasks (Pronk et al, 2004).

  
  

Mental Health Impacts

Active commuting also enhances mental health by reducing symptoms of anxiety and depression. Cycle commuting alone has been shown to result in 20 % reduction in prescription for mental health problems (Friel et al 2024).

Examples of economic and societal value

Apart from the gains for society in reducing the burden on disease from increased physical activity, specific examples of economic and social value include:

• Cost Savings: In Denmark, cycling is estimated to save €0.77/km in healthcare and productivity costs (Transportøkonomiske Enhedspriser, COWI, 2020)​.

• Life Expectancy: Research by Rojas-Rueda et al. (2016) in the Netherlands demonstrated that replacing short car trips with cycling increases life expectancy by 8 months, despite slight increases in exposure to urban pollutants.

  
  

References

• Celis-Morales, C. A., Lyall, D. M., Welsh, P., et al. (2017). Association between active commuting and incident cardiovascular disease, cancer, and mortality: Prospective cohort study. The BMJ, 357, j1456: https://www.bmj.com/content/357/bmj.j1456

• COWI. (2020). Transportøkonomiske Enhedspriser for Cykling. Transport-, Bygnings- og Boligministeriet. Link

• Decisio (2017). Waarderingskengetallen - MKBA Fiets: State-of-the-Art. Ministerie van Infrastructuur en Waterstaat.

• Friel, C., Walsh, D., Whyte, B., Dibben, C., Feng, Z., Baker, G., Kelly, P., Demou, E., & Dundas, R. (2024). Health benefits of pedestrian and cyclist commuting: evidence from the Scottish Longitudinal Study. BMJ Public Health, 2(1), e001295. Link

• Mueller, N., Rojas-Rueda, D., et al. (2020). Health impact assessment of cycling network expansions in European cities. Environmental Research, 186, 109545.

• Pizot, C., Boniol, M., Mullie, P., Koechlin, A., Boniol, M., Boyle, P., & Autier, P. (2016). Physical activity, hormone replacement therapy and breast cancer risk: A meta-analysis of prospective studies. European Journal of Cancer, 52, 138–154.

• Pronk, N. P., Martinson, B., Kessler, R. C., Beck, A. L., Simon, G. E., & Wang, P. (2004). The Association Between Work Performance and Physical Activity, Cardiorespiratory Fitness, and Obesity. Journal of Occupational and Environmental Medicine, 46(1), 19–25. Link

• Rasmussen, M. G., Grøntved, A., Blond, K., Overvad, K., Tjønneland, A., Jensen, M. K., & Østergaard, L. (2016). Associations between recreational and commuter cycling, changes in cycling, and type 2 diabetes risk: A cohort study of Danish men and women. PLOS Medicine, 13(7), e1002076. https://doi.org/10.1371/journal.pmed.1002076

• Rojas-Rueda, D., de Nazelle, A., et al. (2016). The health risks and benefits of cycling in urban environments compared with car use: Health impact assessment study. BMJ Open, 6(8), e009892.

• Wang, J., Huang, L., Gao, Y., Wang, Y., Chen, S., Huang, J., Zheng, W., Bao, P., Gong, Y., Zhang, Y., Wang, M., & Wong, M. C. S. (2019). Physically active individuals have a 23% lower risk of any colorectal neoplasia and a 27% lower risk of advanced colorectal neoplasia than their non-active counterparts: systematic review and meta-analysis of observational studies. British Journal of Sports Medicine, 54(10), 582–591.

• WHO HEAT Tool for Cycling and Walking: Methodology and User Guide (2017). Accessible at: HEAT Tool.