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The Cycling Healthcare Overhaul

By Clarissa Ersoz

Obesity is a growing problem in the United States. The Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), the Surgeon General and other health institutions and professionals have labeled it an “epidemic.” According to the CDC, in 2008 one third of Americans — 72 million individuals — were obese, double the estimated amount in 1980. The WHO attributes this phenomenon to “consumption of energy-dense, nutrient-poor foods high in saturated fats and sugars and reduced physical activity.” Although the WHO and other organizations understand that genetic makeup determines a person’s susceptibility to weight gain, societal changes such as diets with a higher proportion of fats and sugars, the shift to less physically demanding jobs and the increased use of technology, create the foundation for an overweight nation.

Obesity causes a host of health problems including type 2 diabetes, coronary heart disease, hypertension, stroke, liver disease, respiratory problems and osteoarthritis. The National Cancer Institute (NCI) even links it with cancers of the colon, breast, kidney, esophagus, gallbladder and pancreas. The NCI estimates that in 2002 around 3.2%, about 41,000 new cases, were associated with excessive weight and that 14% of deaths from the disease in men and 20% in women were linked to obesity.

According to the CDC, the top three killers in America — heart disease, cancer and stroke — are all connected to being overweight. A study released by the Public Library of Science Medicine states that smoking, high blood pressure and obesity are the leading factors in premature, preventable mortality.

Photo by Jay Stilwell

Simone during the 2009 Courage Classic.

The Surgeon General’s 2010 report entitled, “Vision For a Healthy and Fit Nation,” claims that the rise of this epidemic is connected to many lifestyle factors, including the availability of high-calorie food, the growing sizes of food portions, and reduced physical activity. Clearly, America faces a national obstacle and there have been many proposed solutions: taxes on soda, promoting healthier school lunches, displaying calories on menus, regulating food advertising (especially those targeted at children) and others. Businesses, communities and individuals will have to work together to solve this problem, but there is one relatively simple solution that can make a personal and public difference: choosing to ride a bike.

Cycling provides exercise in an area of life that is unavoidable: transportation. The Bicycling and Walking Benchmark Report for 2010, prepared by the Alliance for Biking and Walking, claims that in 2001, 41% of trips taken in the United States were under two miles long and yet 89% of them were made by car instead of an alternate form of transportation. According to the League of American Bicyclists (LAB), trips of three miles or less can be achieved just as quickly biking as driving, meaning more calories burned and no time lost. Cycling has multiple layers of benefits: it gets people where they need to go while also providing calorie burning exercise that so many lack.

The LAB estimates that a 200-pound cyclist will burn 546 calories in an hour while pedaling at a rate of 12 miles per hour. Riding for recreation or as a means of transport also ensures the 30-60 minutes of recommended daily physical activity. Additionally, biking is a good form of exercise for already overweight individuals since it provides low-impact exercise, which decreases the risk of joint injury. The LAB calculates the annual cost of maintaining a bike to be around $120; this number combined with the health benefits of cycling, means that it actually costs less to be healthy, when doing so typically seems like the more expensive choice.

The Benchmark Report compared the decrease of exercise to the increase of overweight people over the past four decades. Since1960, cycling and walking has dropped by 67% while obesity levels have increased 241% over the same time span. As non-motorized trips decreased, obesity rates surged from around 12% in 1960 to over 30% in 2000. The trend correlated similarly for children. The report found that states with the highest percentage of people who walk and bike have the lowest number of overweight individuals. Those residents also have a lower rate of high blood pressure and diabetes.

The Northwest fairs better than some other regions in the country, but there is still cause for concern. In 2007, 62% of Washington and Oregon’s population were overweight and 26% were obese. Additionally, 7% had diabetes, while asthma rates varied between 9 and 10% and hypertension reached 25 and 27%, respectively. In Idaho, 63% were considered overweight, 25% were obese, and 8% had diabetes; the same percentage had asthma and 26% suffered from hypertension.

As these rates have increased, so too have medical costs. Research conducted by the CDC and the Agency for Healthcare Research and Quality shows that annual healthcare costs related to obesity in the United States have doubled in less than ten years and those numbers may be as high as 147 billion dollars annually. A collaborative report entitled The Future Costs of Obesity, from the United Health Foundation, the American Public Health Association, and the Partnership for Prevention, reports that 103 million American adults will be considered obese by 2018 and taxpayers can expect to spend 344 billion dollars per year on healthcare costs associated with this epidemic, accounting for 21% of overall healthcare spending. If these levels continue to rise at their current rate, by 2018 the costs will be roughly $1,425 per person. Currently, each American adult on average spends $361 dollars annually due to the cost of obesity. A study published in 2005 in the International Journal of Obesity entitled “Impact of Morbid Obesity on Medical Expenditures in Adults” found that after adjusting for race, age, gender, income, marital status, and education, overall per capita healthcare expenditures for morbidly obese adults are $1,975 greater than for normal-weight people.

Photo by Bicycle Paper

Simone during the 2005 Courage Classic.

Cycling not only benefits the individual, but also the public by lowering healthcare costs. “State-Level Estimates of Annual Medical Expenditures Attributable to Obesity,” a study published in Obesity Research in 2004, gives the dollar amount of obesity-related medical expenditures in each state. Generally areas with the highest percentage of non-motorized transport users have the lowest healthcare costs associated with obesity. For instance, the state of Colorado has the least amount of obese, overweight and diabetic people in the U.S., and has one of the highest percentages of residents who choose alternate forms of transportation, with nearly 26% of trips made by foot or bike in 2007. According to The Future Cost of Obesity, in 2008 Colorado had the lowest obesity-affiliated healthcare spending per adult.

Not all people are overweight or obese because of personal choices; many people eat unhealthy food because it is perceived rightfully or not as a cheaper alternative. Many aspects of our national food system have to change before the epidemic can be solved. Cycling offers a relatively simple and accessible solution for many people. If more and more Americans choose to cycle or walk, rates of obesity could decline dramatically and costs of healthcare would follow suit.