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Road to healthy living - George Debono

Photo: Shutterstock

Photo: Shutterstock

What Jean Karl Soler wrote in a recent article titled ‘Irrational rationalisation’ is misleading and needs to be corrected.

He declares himself again, unequivocally in favour of continuing with the destruction of trees to create more road space for traffic and, absurdly, higher speed limits. Both these are counter-intuitive, according to modern thinking.

Reducing traffic congestion has long been traditionally addressed; through more roadway capacity by constructing entirely new roadways, adding more lanes to existing roadways or upgrading existing highways to controlled-access freeways. Numerous studies have examined the effectiveness of this approach and consistently show that adding capacity to roadways fails to alleviate congestion for long as it increases private car use and vehicle miles travelled.

Lower speed limits have been demonstrated to lower road accident mortality.

The correspondent also makes unsubstantiated sweeping statements such as “Bicycles have no place on major roads”, “Increasing bicycle use will necessarily increase road deaths” etc. These are unconvincing, unless supported by proof. Anyway, such claims have already been refuted in previous correspondence to the Times of Malta.

The lack of credibility in Soler’s article can be briefly demonstrated by refuting just one statement, namely, that our prevalence of diabetes (as quoted in another correspondent’s letter some months ago) was “a grossly-inflated prevalence rate”. This counter-argument is, anyway, of general health interest to all.

Malta has the second highest percentage of type 2 diabetes in the Mediterranean, with a prevalence of 9.8 per cent versus 6.4 per cent in the EU (NSO 2013). Fifty-eight per cent of Maltese adults are overweight and 22 per cent are obese. This figure is far higher than the European average and second only to the UK’s (24 per cent).

Malta has yet to recognise the public health importance of active mobility

Diabetes is a growing health problem in Malta. The prevalence of diabetes is rising faster than expected (WHO 2013). This high prevalence of diabetes among the Maltese population is a substantial economic burden.

Transport is an important determinant of health. Sedentary lifestyles as well as obesity and diabetes have increased, in parallel with incomes and car ownership in developing countries. There is now agreement that active transport (public transport, bicycle, walking) is positively linked to lower rates of obesity and diabetes, and improved public health on a nation-wide basis.

Obesity is more prevalent in those countries where people are predominantly reliant on private car transport (and who walk and cycle less). European countries with higher levels of public transport use, walking and cycling tend to have lower rates, not only of obesity, but also of diabetes and hypertension.

The International Diabetes Federation includes promotion of cycling as one of the activities that leads to increasing physical exercise.

Malta has yet to recognise the public health importance of active mobility. Our epidemic of obesity and diabetes has been exacerbated by the surge in car ownership and creeping urban sprawl, which has resulted in an environment that discourages active mobility and made the private car the default mobility option. In addition to street-level pollution from traffic congestion, there are few road characteristics that help to raise the profile of public transport, walking and bicycle use in Malta.

Encouraging private car use by increasing road space (and destruction of trees), as suggested by the correspondent, is simply unhealthy. Also, he wants bicycles off “main” roads by making exaggerated claims about the hazards of bicycle use. He is wrong. The overall positive effect of a reduction in the burden of disease, from increased physical activity of cycling, outweighs the negative outcomes associated with exposure of cyclists to air pollution and injury from traffic accidents by a ratio of between five and 50.

Whatever the prevalence of diabetes, what the correspondent maintains in his article would only serve to increase it by discouraging healthy mobility options. Recommending the car as default mobility option is illogical, unhealthy and outdated. This would literally be dangerous to health on a national level.

George Debono is a retired doctor with a interest in health and environmental issues.

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