Promoting Safe Walking and Cycling to Improve Public Health: Lessons from The Netherlands and Germany

Improving conditions for walking and bicycling in our cities is vital for America’s public health. The measures described in this article would not only reduce pedestrian and cycling fatalities and injuries, they would also allow millions of people, many of them dangerously overweight, to bike or walk for some of their short trips and thus obtain healthful exercise in the course of daily life. More walking and cycling would yield further public health benefits by reducing use of automobiles, thus diminishing air and noise pollution and the overall level of traffic danger. The United States is gripped by a worsening epidemic of obesity. Nationwide surveys based on self-reported weight and height indicate an increase in obesity from 12% of adults in 1991 to 20% in 2000.1 Estimates of obesity based on clinical measurements of weight and height are considerably higher, indicating that in 2000, 31% of the adult population was obese (BMI ≥ 30), and 64% was overweight (BMI ≥ 25).2 Many studies suggest that the lack of physical exercise is one important reason for the alarming trend toward increased obesity. Several articles and editorials in the leading medical and public health journals have explicitly advocated more walking and cycling for daily travel as the most affordable, feasible, and dependable way for people to get the additional exercise they need.3,4,5,6,7 Similarly, the U.S. Surgeon General specifically