I had a deeply emotional reaction to Dr. Anita Kurmann’s death in a bicycle accident at a congested Back Bay intersection earlier this month.
As a physician who bikes to work daily, I pictured myself in the same situation: the morning sun on my face, the quick pace of Massachusetts Avenue, and then — suddenly — a massive truck turning into me. In fact, I was only blocks away on my bicycle at the moment Dr. Kurmann was struck by a flatbed tractor-trailer as it made a right turn from Mass. Ave. onto Beacon Street.
We all find our own ways to cope with the shock and sadness of these too familiar bike-auto collisions and their often fatal outcomes. But as a physician committed to teaching public health and wellness and providing primary care, I am also angered. Biking should not be treacherous. Tragedies like this could discourage people from getting on a bike, and that could be detrimental to their health.
Public health analysts have long studied and published data on the potential impact of biking on reducing obesity. A Centers for Disease Control and Prevention report found that out of 126 metropolitan areas in the United States, those with the highest percentage of residents who walk or bike to work also have the lowest obesity rates. It recommended that cities build bike lanes, racks, and pedestrian pathways to promote more such exercise. That was five years ago.
Though compelling, the data seem intuitive, and there are questions about whether the biking itself drives down obesity rates or if other factors are confounding the outcomes — such as whether people who bike also have access to more nutritious food and better education, both of which are also shown to reduce obesity.
Researchers at Drexel University recently published a systematic review of cities in the journal Obesity Reviews in which they were able to determine what kinds of city interventions did the most to cut obesity. “Active transportation infrastructure,” such as safe bike lanes, was a big one.
As someone who works on the front lines in an urban underserved hospital where there are many facets of the fight against obesity that I cannot always control — such as the injustice of the food and educational systems — this strikes me as good news. Creating bike lanes and making them safe are specific actions that can help lower our ever-burgeoning obesity rates.
There are reasons for optimism — though the numbers are still relatively small, there are more people biking to work than ever. US Census data show the percentage of people nationwide that commuted to work by bicycle rose from 0.6 percent of the total population in 2000 to 1 percent in 2012.
Boston — often at the forefront of health and medicine – is astonishingly average on this front, and far behind cities of comparable size and density in other states. According to the US census, about 1.7 percent of Boston workers commute by bike. That compares unfavorably with cities such as Washington, D.C. (4.1 percent), Philadelphia (2.3 percent), Minneapolis (4.5 percent), and Portland, Ore. (6.1 percent).
In 2015, WalkScore rated Boston as the nation’s third most walkable city, topped only by New York City and San Francisco. So why do so few Boston residents bike to work? Perhaps the discrepancy has something to do with senseless deaths of bicyclists and the fear the incidents instill in us all. A 2014 study cited recently in a Boston Globe story found Boston has more “bicycling fatalities per 10,000 bike commuters than Denver, Minneapolis, Portland, Seattle and Washington, D.C., among cities of comparable size where bicycle travel is common.”
Something as seemingly basic as biking can have widespread effects on a person’s life. A patient I took on in my practice last year came with a lengthy history of chronic illness and conditions, even though he is only in his forties. They include uncontrolled diabetes, high blood pressure, two heart attacks, a blood clot in his lung, and a long history of anxiety and depression. He had also been shot when he was younger, the result of gang-related violence. Together, and with the help of his visiting nurse, we got his medicines in line, got his sugars and blood pressure down, and initiated care with a therapist.
As the patient’s health improved, he started dreaming about things he had always wanted to do but never had. Two months ago, he came to my clinic — his eyes bright — and told me he had bought a bike. “I have always wanted to feel the wind in my hair,” he said excitedly. Not wanting to dampen his enthusiasm, I didn’t mention at that moment that he’d need to wear a helmet. I had never seen him so engaged in his health.
But a moment later, he asked: “Is biking safe in Boston?”
I wish I could have responded with an unequivocal yes.
Boston needs more bike lanes to offer more safety to more people — for peace of mind, and for our improved health. We shouldn’t have to fear riding on city streets.
As for me, people still ask whether I will keep biking to work following Dr. Kurmann’s fatal crash. I wish I could respond with an unequivocal yes.
Dr. Katherine Gergen Barnett is an assistant professor of family medicine at Boston Medical Center.