Health benefits of biking infrastructure

One of the challenges with moving towards sustainability is the separation of different areas of human living into different levels of government. In Canada, municipalities are responsible for municipal transportation systems, including bike infrastructure, while provinces are responsible (mostly) for health systems. This means that spending on one area does not result in savings for the same body in the other.

We had our municipal elections yesterday, and a number of mayoral candidates were adamant that they were going to reduce spending by stopping all planned cycling infrastructure projects. Less than two per cent of the transportation budget is spent on multi-use paths and bike lanes. So I’m not really sure how that is going to address the cost-of-living crisis, but clearly, I don’t see things the same way as these candidates do. At the same time, the provincial government has been attacking public healthcare (really public anything), again, the argument being budget and debt reduction.

Here’s the thing: there are health benefits to expanding city cycling infrastructure. Therefore, spending in one area can create savings in the other. If these both fell under the same governance, this may be an argument that could be used to support improving active transportation infrastructure. But they don’t. So instead, they get treated as two different costs by two unrelated systems.

How connected is bike infrastructure to health benefits? Shen, Williams, and Coutts (2025) asked this question in a large-scale study of multiple cities of multiple population densities. They found that municipalities that implemented more policies to improve biking infrastructure had lower rates of leisure-time physical inactivity, obesity, and coronary heart disease. This was strongest in medium-density cities. Lower-density cities had fewer policies for major cycling infrastructure through a combination of longer travel distances and lower political support. Higher-density cities had more risk due to collisions and pollution, which reduced interest in outdoor physical activities.

The following paragraph from the article by Shen et al is worth quoting within the context of this post:

The benefits of municipality-level bike infrastructure investments may be undervalued when they do not consider the potential health benefits to residents. For example, the total cost of on-road bike lane construction is often less than 1% of regularly scheduled road resurfacing projects (Parker et al., 2013), and the savings in health care costs could make the benefits far outweigh the investment cost. Identifying and monetizing the health impacts of bike infrastructure and integrating these benefits in infrastructure policies has the potential to increase the fiscal feasibility of such projects” (p. 2996).

The authors go on to talk about the siloed process of infrastructure planning, but I think we need to take this a step further. If I ran the world (no thanks), to me it would make sense then for those who fund the healthcare system to provide funding to improve active transportation infrastructure. Alas, instead of doing that, we are seeing, at least in a few provinces in Canada, the provincial governments actually trying to restrict municipalities from building cycling infrastructure while also complaining that healthcare costs too much.

Why do I teach an entire course on systems thinking? The world is not made up of silos. The world is interconnected, and until we actually start to recognize that, we will continue to have the left hand fighting the right hand.