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Treating the Cause of Obesity, not the Effect

GP Management of Obesity

Exercise - the Nature Fix

Health Promotion Through Cycling

Last Modified 1/12/98

Until the 20th century, health was described in terms of vigour and stamina. Now the health of 80 per cent of the population could be improved by exercise, yet one of the commonest reasons given for not exercising is being 'too tired'.

We should now ask: "What is the future of health?" If we don't spend some time visualising the future we want, we have no chance of getting it. Cycling advocacy is most effective where it is incorporated in mainstream thinking. If cycling is seen only as a sport or a developmental toy for children we can't expect funds to be allocated to cycling. If cycling for transport can be incorporated in government policy then we can expect significant, sustained funding for cycling. We have seen this in parts of europe and, from Australia, Holland appears to be a good example of this. The challenge in most countries is to have cycling given higher priority. A few years ago the Schering Foundation brought experts on the future and senior executives together to try to identify how 'health' would develop in the next century. This group proposed four possible scenarios for health care in the next century:

1. Status Quo Basically an extrapolation of the current system. This scenario is unlikely to occur.

2. Bust economic hard times result in government intervention to control costs by rationing treatment and by not introducing expensive new drugs or surgical procedures.

3. The third wave Assumes that a healthy lifestyle becomes a therapy in its own right and that an information revolution permits customised therapy from a range of providers.

4. Frugal and healthy The world moves from materialistic values towards quality of life concerns. Information systems are extended to allow outcomes to be monitored so that only effective treatments are used. Health care becomes more frugal with an emphasis on prevention, self-care and holistic therapies.

In the short term, scenario one (status quo) is quite likely but in this scenario the cost of providing health care will continue to rise. This cannot be sustained and will inevitably lead to the bust of scenario two. We may be closer than we think to this. Rationing of treatment is already occurring by stealth in many countries and every year more people are unable to gain access to the treatment they require.

We have possibly started to move towards scenario three (third wave). The first 'health monitoring' programs in which clients enter their personal information and are given advice on maximising health are just beginning to appear. They are on the internet, some are presented by health insurance companies and they are not only information-rich but also have the skills to appraise and act on the information. There is one feature common to all those I have investigated - they tell the client to exercise.

Frugal and healthy scenario four is where cycling advocacy must lead. Cycling as transport takes us beyond preventative medicine to what the World Health Organisation calls primordial health promotion. By creating a culture where exercise is natural and valued, many of the illnesses we are currently grappling with how to afford will become unusual. I believe the most logical, cost-effective, and co-incidentally environmentally friendly, way of introducing exercise into daily life is through human-powered transport for all but the shortest journeys - cycling.

Ass Professor Harry Owen
School of Medicine
Flinders University, SA
Reproduced with permission of Australian Cyclist magazine