Tāmaki Innovation Campus

Cycling’s vicious circle can be turned around

Dr Sandar TinTin was inspired to specialise in the area of public health when working as a medical resident and realising that treating individual patients did not deal with the root of the problem.

Cyclist vs car is a frequent headline in the media, and cycling’s travel, injury risk and conspicuity was the content of Sandar TinTin’s doctoral research.

She grew up in a Myanmar city where cycling was common, learning to ride at seven, and cycling on the road without adult accompaniment at ten. Cycling to school and other day-to-day activities, she enjoyed freedom and independent mobility and avoided serious injury despite not using helmets or high visibility materials (neither expected nor commonly used).

But increased traffic in a bigger city, with a more complex transport environment, halted her cycling as she pursued her medical studies.

She moved to New Zealand to undertake a Master of Public Health, noting few cyclists on Auckland roads. Initially she thought it signalled a developed nation, but realised her misconception on visiting Europe and noting the popularity of cycling.

“This stimulated my interest in investigating the epidemiology of bicycle travel and associated injury risk in the New Zealand context. I chose this for my doctoral thesis when I was appointed to the Taupo Bicycle Study, a large prospective cohort study of cyclists. This was also in line with my interest in epidemiological research and desire to expand my knowledge in epidemiological analyses,” says Sandar.

The context was that cycling is an efficient mode of transport in terms of time, space and money, and improves social cohesion and transport equity; increasing  physical activity, improving health and reducing greenhouse gas emissions, but safety concerns, particularly related to traffic danger, limit cycling.

While not involved in the initial recruitment phase of the Taupo Bicycle study in 2006, she gained a project grant from the Health Research Council in 2009 to undertake follow-up activities.

“Like many other PhD students, I faced challenges,” she says. “However, I appreciated the consistent support and insightful guidance from my supervisors, Professors Alistair Woodward and Shanthi Ameratunga.”

As a result, Sandar was one of two New Zealand-based PhD students invited by the Royal Society to present the findings at the first Commonwealth Science Conference in Bangalore, India in 2014.

Her main findings were as expected, with the prevalence of bicycle commuting low in New Zealand and in decline between 1986 and 2006 (but with signs of recovery more recently). The rate of bicycle crash injuries per time spent travelling was relatively high, compared to other road user categories. There were regional differences in travel patterns and injury risks, which suggested the existence of the “risk in scarcity” effect for New Zealand cyclists, ie cycling is more dangerous if fewer people do it.

New Zealand had been caught in a vicious circle, with a lower proportion of cyclists on the road decreasing their conspicuity and posing a higher crash risk, which in turn discouraged bicycle use.

Turning this vicious circle to a virtuous one requires cooperative and multi-disciplinary efforts, and she sees opportunities for environmental changes to reduce collision crashes. Such as, self-explaining roads that lower speeds and attract pedestrians and cyclists, well-designed cycle lanes and segregated cycle paths, and intersection treatments that minimise conflicts between vehicles and vulnerable road users.

These supportive measures, if implemented alongside policies to restrict car use (congestion charges, reduced car parking and car free zones), are likely to promote a modal shift and create a better balanced transport system.  

Post PhD, Sandar has joined the Cancer Epidemiology research, investigating the prevalence, demographic profiles and clinical outcomes of genetically-defined subtypes of lung cancer and accessibility of genetic testing and targeted therapy in a large nationwide cohort of lung cancer patients in New Zealand. The project is led by Professor Mark McKeage from Clinical Pharmacology, and Sandar and Professor Mark Elwood are providing epidemiological inputs.

Sandar has been awarded the AMRF Perpetual Guardian David and Cassie Anderson Postdoctoral Fellowship to work on this project. She is also involved in two breast cancer projects from the Waikato Clinical School and is working with Dr Susan Bigby from the Middlemore Hospital for an endometrial cancer project.

And, after a cycling childhood, does she cycle in New Zealand? No.