Cities, bikes, diabetes, flu shots and positive externalities

A recent report from the Institute for Clinical Evaluative Sciences (ICES), maps diabetes rates in Toronto's 140 neighbourhoods.

Here’s the Star’s summary:

The report's most startling finding is that urban sprawl – not just poverty and an immigrant population at greater risk – is contributing to diabetes rates in the city's poorest neighbourhoods that are almost triple those in more densely populated areas downtown. <snip> They found diabetes rates climbed in low-income, high visible-minority neighbourhoods the more residents depended on cars and the further they had to travel to grocery stores and other services.

The (US) CDC is all in favour of curing diabetes through biking and walking.

The Centers for Disease Control and Prevention is considering public promotion of the "co-benefits" of fighting global warming and obesity-related illnesses through everyday exercise, like walking to school or work, said Dr. Howard Frumkin, director of the CDC's National Center for Environmental Health.

"A simple intervention like walking to school is a climate change intervention, an obesity intervention, a diabetes intervention, a safety intervention," Frumkin told The Associated Press. "That's the sweet spot."

The key is getting people out of the car, Patz and Frumkin told the public health association at its annual convention. Reducing car travel in favor of biking or walking would not only cut obesity and greenhouse gases, they said, it would also mean less smog, fewer deaths from car crashes, less osteoporosis, and even less depression since exercise helps beat the blues.

Ahh. A simple public policy issue: to increase health, increase urban density and active transportation options, right?

Not so straightforward in Toronto. This city, which used to be a leading edge city for bicyclists, has fallen behind the rest of the world. The evidence? Current estimates are that the 500 km of bike lanes slotted into the official plan for 2011 will in fact be complete in 2070.

At the same time Toronto is lagging, a new public transit system of short term bike rentals, la Vélorution, is springing up all over the world.

Chicago is interested, and so is Moscow. Geneva and Sydney are in negotiations, and the mayor of London has called by twice. All eyes are on Paris. But what is the big attraction? It's a brand new model of bicycle, one that can be seen teeming through the streets by the thousands, all the same chic silver-gray, with a dolphin-like design. And they are all rented.

Paris has suddenly become the world capital of bike rentals. Nowhere else in the world has quite so many rental bikes standing at the ready: there will soon be over 20,000. And the fleet is really being put to use: commuters pedal from the Metro to the office, managers pop out in their lunch breaks to pick up groceries, tourists zigzag in every direction. More than six million rides have been clocked up in just three months -- there is hardly a faster way to get through the legendary tangle of the French capital.

Not in Toronto, which axed its hugely popular Bikeshare programme because it cost $80,000 per year.

What does this have to do with flu shots?

Over at Marginal Revolution, Alex Tabarrok explains that people who get flu shots reduce not only their own risk of flu, but that of everyone around them.

People who have the flu spread the virus so getting a flu shot not only reduces the probability that I will get the flu it reduces the probability that you will get the flu.  In the language of economics the flu shot creates an external benefit, a benefit to other people not captured by the person who paid the costs of getting the shot.  The external benefits of a flu shot can be quite large.  Under some conditions each person who is vaccinated reduces the expected number of other people who get the flu by 1.5.

They create positive externalities.

There are thousands of potential cyclists in Toronto, who could be living longer and healthier lives while reducing the whole society’s greenhouse gas emissions and medicare expenses. They aren’t biking because of the risks and costs they will personally incur.

How many times do we see this? Positive externalities are the side effects that cause spillovers of goodness, saved costs and lives, healthier options. All too often they are discounted.

Cities are vast reservoirs of positive externalities in employment, transportation, education, recreation and services. People migrate to cities hoping for all those happy spillovers to land on them.

A successful city identifies and builds new mechanisms to create these positive externalities, whether it’s flu shots or bike lanes, schools, transit, parks or libraries.

Tabarrok suggests that we kiss the inoculated. At this point, Toronto’s cyclists would appreciate bike sharing and dedicated lanes as least as much as kisses.

posted for Alison Kemper (by Kevin Stolarick)