Going nowhere slowly in killer traffic the “Alaskan Way” in Seattle/Tony Webster, Wikimedia Commons

Millions dead give new meaning to ‘killer traffic’

Forget for a moment the pandemic – if that is possible – and turn your attention to a very good study out of England with a very bad name that outlines what is really the leading cause of early death in the Western world.

The study is sadly and inappropriately titled “Car harm: A global review of automobility’s harm to people and the environment” as if cars were responsible for the problem in need of a fix. Cars aren’t the problem.

Modern-day urban planners who’ve designed cities for motor vehicles instead of people, cowardly politicians who’ve embraced the idea everyone should be able to drive everywhere as fast as possible in those cities, and lazy people intellectually unable or unwilling to recognize what motor vehicles are doing to their health and that of their neighbors are the problem.

Blaming cars instead of the people in the cars for the health and environmental problems associated with killer traffic only provides fuel for the anger of those who want to believe there is some sort of global “War on Cars” as Car and Driver magazine first proclaimed in 2018:

“‘When they come for our cars,’ imagined the founding fathers of this magazine, ‘Big Government will be behind it,’ Features Editor Jeff Sabatini wrote then. “This stood to reason, as that was the case with safety mandates, emissions regulations, and the double-nickel era, the policy triumvirate that so riled the libertarian spirit of this institution in years past.

“Short of an outright ban, the feds, aided and abetted by the bureaucracies of certain states, would most certainly continue their overreach, eventually all but proscribing the car via requirements too onerous to meet. Uncle Sam’s safety nannies, fuel-economy standards, and untenable restrictions on the very act of driving itself would make new cars so dull, slow, and expensive that we would welcome riding the bus. Or so we thought.

“This is not how the war on cars is playing out. City governments are the ones taking the lead in creating policies to curtail automobile use in response to congestion and pollution. There are taxes, restrictions, and prohibitions, of course, yet other policies on road design, speed limits, and parking are being devised to entice city dwellers to opt out of car ownership all on their own. At least that is the hope.”

Reading Sabatini then, you’d almost expect to find American cities nearly devoid of cars by now when the reality is the opposite. Most of them, like Anchorage, are overrun with motor vehicles and too often gridlocked for this reason.

This is not the fault of the cars. It is not the cars doing harm. Cars – like chainsaws or knives or firearms – are merely tools. You can use a chainsaw to craft a cozy log cabin or clearcut a forest. You can use a knife to carve the Thanksgiving turkey or slice up your neighbor. And you can use a firearm to save your life or murder an acquaintance.

Car addiction

Then again, chainsaws, knives and guns aren’t addictive, so maybe cars are more like opiate-based painkillers, great for easing your pain but problematic if you become addicted to them.

And much of the Western world is now addicted to the ease of being moved about by motorized power. This addiction drives what the study defines as “automobility’s harm to people and the environment.”

Ironically, the people this automobility harms most are the people in the automobiles.  As with drug addicts, they are the biggest victims of their addiction.

“Accounting only for crashes and some forms of pollution, approximately 1.67 million people per year die as a result of automobility,” the Car Harm study calculates “This means that cars and automobility cause 1 out of 34 deaths.”

But these deaths are only the tip of a much bigger iceberg.

The 1.67 million are a minimum estimate of “deaths from traffic-related air pollution and some types of vehicle-based lead exposure,” the authors write. “Our estimates do not include the contribution of automobility toward illness and death caused by” the encouragement of sedentary behavior.

Still, the authors could hardly overlook this huge and still growing threat to the masses.

“Over the past few decades, children have become increasingly sedentary in their travel, particularly in the most car dependent countries,” the study admits. “In the U.S., the proportion of children who walk or cycle to school has decreased from about 48 percent in the 1970s to 10.7 percent in 2017. One reason for the decline in walking to school across multiple countries is the danger posed by cars: ‘There is too much traffic for Alex to walk to school, so we drive.'”

This behavioral shift has lifetime consequences.

“Sedentary behavior, including car travel, increases the risk of ‘all-cause mortality, cardiovascular disease mortality… cancer mortality, and incidence of cardiovascular disease, type 2 diabetes, and cancer,” the authors of the study wrote while somehow overlooking the elephant now in the room – that being the huge number of pandemic deaths related to sedentary lifestyles.

Sit and die

At this time, the U.S. alone has witnessed nearly 1.22 million deaths linked to the pandemic, SARS-CoV2 virus that causes the disease know as Covid-19. For about 5 percent of these deaths, the U.S. Centers for Disease Control reports, “Covid-19 was the only cause mentioned on the death certificate.”

The other approximately 95 percent had something else going on in addition to a SARS-CoV-2 infection. Most of the dead were already suffering from what Americans once called chronic diseases but now call comorbidities, and a huge number of these comorbidities/chronic diseases track back to the sedentary lifestyle encouraged by motor vehicles.

“In car dependent places, (which would be most of the U.S.), many short journeys are made by car when they could be made by physically active modes,” the Car Harm authors wrote.

Such behavior is not unique to the U.S. Dr. Scarlett McNally, president of the Medical Women’s Federation in England, took to the pages of the British Medical Journal (BMJ) earlier this month to warn against the continuing trend of driving too much and walking too little.

“There is an urgent need to improve the nation’s health, which worsened over the pandemic,” she wrote. “There is an abundance of evidence and reports, including by me, claiming that exercise is a miracle cure that improves physical and mental health and reduces demands on National Health Service services and the need for social care.”

McNally is among a minority of Western physicians who have recognized exercise is medicine and embraced the idea that the cure for what ails a lot of Westerners these days is not another vaccine or drug but getting them up off their asses and moving.

The American College of Sports Medicine has initiated an “exercise is medicine” campaign to make the promotion of physical activity a standard in clinical care, but it is facing an uphill battle. There is a lot more money to be made in pushing drugs and surgical treatments than in advocating for exercise, and a lot of physicians are as deskbound and lazy as their patients.

The problem with exercise as medicine is that it requires more effort than sitting behind a computer surfing the internet or lounging on the couch to binge on the latest video series streamed by Netflix/Prime/Max/Apple/etc. in a world where the video-streamed series is the new novel.

The consequences of this decades-long shift from moving less to sitting more are nicely underlined in a new, peer-reviewed study published in the British Journal of Sports Medicine that looked at the consequences for the sitters.

What a study of more than 72,000 elderly Brits, average age 61, found was that those who got up on their feet to stomp or stumble for more than 8,000 steps per day had about a 45 percent lower chance of all-cause death than those who walked less than 4,000 steps in a day.

The authors of that study also found a dose-response relationship between steps and health that led them to conclude that “9,000 to 10,500 steps per day was associated with the lowest mortality risk independent of sedentary time.”

Best of all here is that higher quantity of daily steps actually offset the damage done by sitting. This was the study’s biggest and argumentably most important finding.

People who sit a lot (and most white-collar work has unfortunately made sitting part of the job) can make up for the life-shortening and too often deadly effects of tapping away on a computer for most of the day by walking more when they are not behind the computer.

Once again, let’s return to the example provided by the newly evolved (or manufactured) virus that drove the pandemic. It killed very few of the truly healthy. It mainly shortened the time those already on the slide toward the grave took to get there. This was something recognized early in the global crisis.

Researchers in England in July 2020, just months into the pandemic, revealed that an examination of the health records of more than 400,000 people enrolled in the UK Biobank showed that those classed as “normal weight” brisk walkers, those who displayed the “greatest whole-body physical fitness,” had about a third the risk of a “severe” SARS-CoV-2 infections and an even lower rate of the death from the associated disease called Covid-19 than “normal weight” or obese slow walkers.

Even obese brisk walkers cut their risks of severe Covid-19 about in half. They didn’t gain enough protection from exercise to match “normal weight,” “steady/average walkers,” but they were close. In the rankings of protection in that study, normal-weight brisk walkers were at the top followed by normal weight, “steady/average walkers” with overweight and obese brisk walkers basically matching overweight “steady/average walkers” in the degree of protection.

But even obese “steady/average walkers” had lower risks than any walkers in the slow walkers’ category where weight pretty much became a non-factor.

The study did not look at the number of steps being taken by these walkers, but people with “the greatest whole-body physical fitness” usually get there by exercising more than their neighbors given that there is no pill that provides this health benefit.

Americans, however, don’t seem to care.

Inactivity’s deadly cost

A peer-reviewed study in Nature in 2017 concluded that the average American was then taking about 5,100 steps per day as part of their daily routine or about half as many steps as the 9,700 of residents of Switzerland, where there are still some mountain communities where the main form of transportation is one’s feet.

The consequences of this difference at the population level were and are neatly recorded in lifespan data.

The average lifespan in Switzerland, as of 2022, was 84.11 years. The average lifespan in the U.S. as of the same year was 76.4, according to the CDC. The U.S. lifespan peaked at 78.9 years in 2014 and generally flatlined until 2020 when the pandemic caused it to nosedive.

By 2021, it was down to 76 years, according to a World Bank chart but has been rebounding since. The Swiss also suffered from the pandemic with a lifespan of 84 falling to 83, but Swiss lifespans had almost fully recovered from the pandemic by 2021, according to the same World Bank data.

The 2017 study published in Nature estimated that there were then “5.3 million deaths per year associated with in-activity” and linked shorter U.S. lifespans and poor American health to the lack of “walkability” in U.S. cities.

The study was conducted by a group of Stanford University scientists who tracked the mobile phones of more than 717,000 people to see how much they moved. One of their key findings was that “in more walkable cities, activity is higher on weekdays during morning and evening commute times and at lunch time and on weekends during the afternoon. This indicates that walkable environments increase physical activity during both work and leisure time.

“We (also) find that higher walkability is associated with significantly more daily steps across all age, gender, and body mass index groups.”

There are about 2,000 steps in a mile. If the average American is now getting about 5,000 steps per day in the normal course of life, he or she would need to walk only about two miles per day to reach the 9,000 steps that the BMJ study found “associated with the lowest mortality risk independent of sedentary time.”

For some, that might be as easy as walking a mile from home (or a car park) to work in the morning and again in the evening. Or maybe riding a bike about three times that distance each day, given the energy savings of pedal power.

Or this would be easy if cities were designed to accommodate walking or cycling. But since 2017 most U.S. cities have become even less walkable as motor vehicle addiction, or “motonormativity” as it has been labeled by English psychologists studying  “social norms hiding major public health hazard,” has continued to set the transportation agenda.

Some in England are actively trying to change this and finding some success. Walking and cycling have boomed in parts of the country and especially in London where the city reports “weekday cycling volume” witnessed a “22 percent increase since 2019.” It is now hard to overlook the large numbers of Londoners daily commuting to work on bicycles or e-bikes although McNally argues the local government has done far too little to promote this trend.

“The best forms of exercise are those that fit into everyday life,” she wrote. “Active travel is a ‘best buy’ for improving health. Commuting by cycling reduces incidence of, and mortality from, heart disease and cancer by over 30 percent in a dose-dependent manner and reduces sick days and depression.

“(But) people don’t swap from their car to active travel because cars are normalized and our infrastructure is built around them. This means that 71 percent of women (and 61 percent of men) say it is too dangerous to cycle on roads. Where there are segregated safe cycle routes, people use them, as has been demonstrated in Paris.”

Americans don’t appear as fearful of venturing near roads without an armored cage around them, but the problem with active travel in the U.S. appears even worse than in England.

Data gathered from the U.S. Census Bureau’s annual American Community Survey along and the periodic National Household Travel Survey by the US Department of Transportation and compiled by The League of American Bicyclists shows the percentage of Americans walking to work today is about half the number of 1980 while biking, which showed signs of growth in the early 2000s, appears to have peaked in 2014 and begun a gradual decline.

There was a notable increase in biking between 2021 and 2022, but whether that was due to a pandemic rebound or the increase in sales of e-bikes, which make it easier to pedal to work, is unclear.

E-bikes are catching on in the U.S., but not in the way they have in Europe due to this country’s lack of infrastructure, the fear of the dangers of American roadways, and a lack of government support.

The U.S. government has been all in on subsidizing purchases of electric cars, but E-bikes are another story despite the all the evidence indicating they are 20 to 35 times better than electric cars at reducing the greenhouse gas emissions, which half of American Democrats now believe a greater threat to humanity than nuclear war, according to the latest polling.  

Despite this, Congressional Democrats in 2022 balked at subsidizing e-bike purchases because of the expense, and, as The Verge reported, killed a proposed bicycle commuter benefit “to make available pretax commuter benefits to cyclists similar to those who drive” motor vehicles.”

Meanwhile, the University of Peninsula has estimated the country is now on track to subsidize electric cars and truck to the tune of $393 billion with most of benefits going to wealthier Americans as Reuters reported.

Both leased and purchased electric vehicles (EVs) qualify for tax credits up to $7,500 on EV bought for less than $55,000. Vehicles over that pricepoint were disqualified so that this federal program wouldn’t look like a total giveaway to the rich.

Sthill, the $55,000 pricepoint is more than $10,000 above the average $44,331 cost of a non-luxury vehicle in the country today, according to Cox Automotive, and more than twice the price of the $25,045Honda Civic that Car and Driver magazine rated the best compact car on the market.

For the cost of the same $7,500 giveaway to each of the people who can afford pricey cars, the could have bought three or four e-bikes to give to people of lesser means, and the English experience is that more than a quarter of ebike users abandon their motor vehicles for all but long tricks.

And the Auto Trader website in September reported that its polling found 47 percent of Brits thinking e-bikes have become a viable alternative to motor-vehicles for shorter journeys.

The state of Conneticutt, which has begun subsidizing ebike purchases to the tune of up to $1,500 on $3,000 bikes, said its decision to do so was driven by the combined benefits of health improvements, environmental protection and reductions in traffic congestion:

“One study found that a 10 percet shift from cars to bikes resulted in a 40 percet reduction in traffic,” it said in a public statement. “From cleaner cities to lower healthcare costs and improved quality of life, the advantages of this program will far outweigh the costs.”

But few states are rushing to follow its example. Why?

Motornormativy; left, right or center; young, old or in between; fat, thin or average, the majority Americans simply don’t want to move under their own power, even if motor assisted, because they are addicted to the ease and comfort of driving everywhere even if is slowly killing them.