June 13, 2013, 11:15 a.m. EDT
Why cities refuse to use health funds for cycling programs
By Jen Wieczner
In addition to mandating health insurance for all Americans, the Affordable Care Act sets aside money that can be used for bicycle projects — but bike advocates have been pedaling right past these piles of cash. Why? Because the only thing more controversial this summer than sharing bicycles may be sharing the burden of health-insurance costs.
As part of Obamacare, grants were established to help cities prevent diseases like obesity, including by making communities “safe and easy for people to walk and ride bikes.” But of 85 cities with progressive biking infrastructure, none used public health dollars for the projects, according to a recent survey by the Green Lane Project, which campaigns for public space dedicated to bikes.
The connection between health-care reform and bicycles may seem tenuous, but studies in the U.S. and Europe have shown health and cost benefits of bicycling. Half an hour of daily cycling could cut a person’s health-care costs by $544 a year, not to mention the potential savings on fuel, according to an analysis published in the Journal of Physical Activity and Health in 2011.
But in setting up municipal bike projects, experts say, cities have largely ignored the law’s Prevention and Public Health Fund because it’s a political pothole. Instead, they’ve pursued private sponsorship and federal transportation grants, which bike-share administrators say are less politically controversial.
“We have federal legislatures concerned that jungle gyms and bike lanes aren’t doing anything for health,” says Linda Shak, program manager at the health non-profit Prevention Institute. Consequently, “there might be people in the community who say, Is bike share really going to address our biggest challenges around chronic disease?”
Indeed, bike initiatives have been a frequent punching bag for critics of the health reform law, and policy experts say the backlash against bike programs could chip away at the law itself. Republicans have repeatedly singled out bike initiatives like paths and signs in lampooning the Affordable Care Act. The House Energy and Commerce Committee recently tried to eliminate the Prevention Fund altogether, deeming it a “slush fund” spent on “signage for bike lanes” in Pitt County, N.C., which received an ACA-funded grant.
“You’re spending billions of dollars out of a preventive health-care fund for things like bike trails,” says Ken Hoagland, chairman of Restore America’s Voice Foundation, a political action committee campaigning to repeal the Affordable Care Act. “Why aren’t you spending that money to help people with preexisting conditions?”
The Nashville Health Department received a $7.5 million grant from the Centers for Disease Control and Prevention for health initiatives including a bike-sharing program that launched in December. But the city would have preferred financing through transportation funds, which would have raised fewer eyebrows, if it had been available, says Tracy Buck, the Health Department’s prevention and wellness director. “To put in a bike lane that’s going to reduce the obesity rate?” People don’t see how that works, Buck says. “That’s more of a stretch of a sales pitch.”
While it costs $100,000 to $150,000 to install a single mile of protected bike lane, it is difficult to measure the return in terms of medical savings, especially when many bike projects are in their infancy, says Martha Roskowski, director of the Green Lane Project. “Those programs are seen as fluff.”
The doubts and opposition may have led other cities to leave public health funds on the table when building their bike programs. While bike-share feasibility studies for various municipalities identify CDC grants as a potential source of funding, new and forthcoming programs in New York, Chicago, Fort Worth, Atlanta and Cincinnati have not used health money, according to announcements and publications from the cities.
And while New York City’s health department originally aimed to “fully implement bike share in all five boroughs,” according to department documents, the bike-share system launched in May in only two boroughs, and city officials say they do not have funds to expand it. Also see: Bike share skips many
But the condensed program has upset residents and city council members in neighborhoods without bike-share stations, who say access to bikes would help combat their local obesity problems. “We need it,” Councilman Ydanis Rodgriguez, representing Northern Manhattan neighborhoods between Harlem and the Bronx, said at a recent city council hearing. “Obesity is one of the issues that if we encourage people to also use bikes, I think it will help a lot.”