The Mobility Initiative at Nurses Drawdown encourages nurses to promote individual-level fitness as well as the health of communities and environments. Active transport (walking, bicycling) and the use of mass transit (riding a bus or train) are solutions to address human health and the health of the environment. Nurses who journey by foot or bike or travel using mass transit – and who encourage their patients to do the same – are promoting personal physical health through increased physical activity as well as the health of the planet through decreased emissions. Furthermore, nurses can use their influence to advocate for cities that are more walkable, bicycle-friendly, and rich in mass transit options.
This solution is unique as we have combined several of the original Drawdown solutions to create it. This solution includes: bicycles, walkable cities, carpooling, public transit and telepresence.
Well-developed bicycle infrastructure can reduce emissions by up to 2.56-6.65 gigatons of CO2 by 2020-2050. According to Project Drawdown, good bicycle infrastructure includes: networks of well-lit, tree-lined bike lanes (it is best when they are direct, level, and interconnected); well-designed intersections, traffic circles, and points of access where bicycles and cars meet; access to public transport, secure bike parking, bike-share programs, and workplace showers (Project Drawdown, 2020a). Supportive policies and programs are helpful in complementing bike infrastructure. Educational initiatives that target both cyclists and motorists are important (for example, ensuring cyclists are obeying the laws of the road and motorists give cyclists the space they require). According to Project Drawdown, more people will take up cycling as a primary mode of low-carbon transportation if there is more, and better, infrastructure.
E-bikes can reduce emissions by up to 1.31-4.07 gigatons of CO2 by 2020-2050. E-bikes are currently the most environmentally sound means of motorized transportation. They have higher emissions than a regular bike, but they are still better than driving cars (even electric ones!) (Project Drawdown, 2020b).
Walkable cities can reduce emissions by up to 1.44-5.45 gigatons of CO2 by 2020-2050 and prioritize low-carbon transportation over motorized vehicles. By making the choice to walk or bike more appealing, they are able to minimize the need to use a car. When developments are more compact, people drive 20-40% less (Urban Land Institute, 2010; Project Drawdown, 2020c). Walkable cities “… have walk appeal, thanks to a density of fellow walkers, a mix of land and real estate uses, and key design elements that create compelling environments for people on foot.” They include: “high density of homes, workplaces, and other spaces; wide, well-lit, and tree-lined sidewalks and walkways; safe and direct pedestrian crossings; connectivity with mass transit” (Project Drawdown, 2020c).
Carpooling can reduce emissions by up to 4.17-7.7 gigatons of CO2 by 2020-2050. Benefits of carpooling include: people splitting costs of travel, ease of traffic, and lightening the load on infrastructure while also reducing emissions per person. “When fuel is cheap, carpooling declines. An abundance of free or cheap parking also steers people to journey solo. So does the desire for autonomy, privacy, and expedience” (Project Drawdown, 2020d).
Moreover, public transit can reduce emissions by up to 7.51–23.36 gigatons of CO2 by 2020-2050. “All mass transit modes use scale to their emissions advantage. When someone opts to ride a streetcar, bus, or subway rather than driving a car or hailing a cab, greenhouse gases are averted… By reducing the volume of cars, mass transit relieves traffic congestion. With fewer people driving, fewer accidents and fatalities take place. Overall, air pollution drops. Mass transit also makes cities more equitable by providing mobility to those who cannot drive” (Project Drawdown, 2020e).
Urban transportation is one of the largest sources of transportation-related emissions. Good urban design and mass transit can help increase mobility, livability, and sustainability in cities.
Telepresence can reduce emissions by up to 1.05-3.8 gigatons of CO2 by 2020-2050. “By integrating a set of high-performance visual, audio, and network technologies and services, people who are geographically separated can interact in a way that captures many of the best aspects of an in-person experience” (Project Drawdown, 2020f).
Through the use of technology, it is possible to reduce the need to travel. If people can work together virtually, they can avoid a host of travel-related emissions. Other benefits include: “… cost savings from avoided travel, less grueling schedules for employees, more productive remote meetings, the ability to make decisions more quickly, and enhanced interpersonal connection across geographies” (Project Drawdown, 2020f).
Air pollution associated with motor vehicles and other high carbon modes of transportation reduce air quality, increase rates of respiratory and cardiac illness, and threaten human life. “Pollution is the largest environmental cause of disease and premature death in the world today. Diseases caused by pollution (such as respiratory or cardiovascular illnesses) were responsible for an estimated 9 million premature deaths in 2015—16% of all deaths worldwide— three times more deaths than from AIDS, tuberculosis, and malaria combined and 15 times more than from all wars and other forms of violence. In the most severely affected countries, pollution-related disease is responsible for more than one death in four.
Pollution disproportionately kills the poor and the vulnerable.
Nearly 92% of pollution-related deaths occur in low-income and middle-income countries and, in countries at every income level, disease caused by pollution is most prevalent among minorities and the marginalised. Children are at high risk of pollution- related disease and even extremely low-dose exposures to pollutants during windows of vulnerability in utero and in early infancy can result in disease, disability, and death in childhood and across their lifespan” (Landrigan et al., 2019). Fine particulate air pollution generated by transportation killed 1063 Canadians in 2015, resulting in a loss of economic welfare for Canadians valued at approximately $8 billion dollars (Howard et al., 2019)
This is relevant to all healthcare workers, but nurses especially will be working with populations whose health are directly threatened by pollution. Low-carbon modes of transportation are co-benefits. In other words, actions that promote health and promote planetary health by reducing greenhouse gas emissions. By promoting low-carbon modes of transportation, nurses (and other healthcare workers) can help encourage healthy lifestyles to their patients and among themselves. The Government of Canada suggests at least 2.5 hours of activity per week to achieve the health benefits of physical activity (Government of Canada, 2018). Low-carbon modes of transportation could help Canadians achieve this goal.
Of the 43.5 million healthcare workers around the world, it is estimated that 20.7 million of those are nurses and midwives (World Health Organization, ). These nurses need to get to work somehow. If we can use low-carbon modes of transportation and encourage others to do the same, we can make a big impact. Highlight the co-benefits of low-carbon modes of transportation: cycling also burns calories and keeps the heart and lungs healthy. Nurses can challenge colleagues to health-competitions that also focus on promoting low-carbon transportation! For example, nursing leaders working in a hospital can organize for a hospital-wide competition whereby each unit is one team. Each team can be challenged to find alternative ways of getting to work besides driving themselves in their car (e.g., car-pooling, bicycling, running, taking public transportation). At the end of the month, whichever unit saves the most mileage wins!
Nurses can try to organize individuals who live in the same area to walk/run/cycle to work together; encourage carpooling between staff and initiating carpooling systems; and lobby their towns and cities for a reduced price on transit passes for healthcare employees. When possible, nurses working in certain community settings can use technology and telepresence to conduct meetings with clients as opposed to driving out to see them. This reduces both cost and emissions. Nurse educators may also be able to use technology and telepresence to teach and meet up with students and colleagues, working from home as possible. This will also reduce cost and emissions.
If you live in British Columbia, and are keen to bike to work, we recommend using this great platform for logging in your teams and your mileage: GoByBikeBC. It is also inspiring to see others across the province commit to the same, to joining a movement, and there are great prizes to win for the spring and fall bike to work week events.
Finally, it is important to unite nursing voices and get involved in municipal-level politics. Together, we can advocate for better walkable infrastructure and demand for this to be a priority. We encourage nurses to advocate for the town or city bus fleet to be composed of electric buses, and for there to be bicycle racks to facilitate multi-modal transport. Demand a strategy from your town or city for how they plan to address climate change. You may find that there are already groups of fellow citizens working on this, whom you can join. It’s inspiring to find like-minded individuals!
Government of Canada. (2018). Physical Activity Tips for Adults (18-64 years). https://www.canada.ca/en/public-health/services/publications/healthy-living/physical-activity-tips-adults-18-64-years.html
Howard, C; Buse, C., Rose, C., MacNeill, A. & Parkes, M. (2019). Policy Brief for Canada. The Lancet Countdown on Health and Climate Change. https://storage.googleapis.com/lancet-countdown/2019/11/Lancet-Countdown_Policy-brief-for-Canada_FINAL.pdf
Landrigan, P. J., Fuller, R., Acosta, N., Adeyi, O., Arnold, R., Basu, N. N., Baldé, A. B., Bertollini, R., Bose-O’Reilly, S., Boufford, J. I., Breysse, P. N., Chiles, T., Mahidol, C., Coll-Seck, A. M., Cropper, M. L., Fobil, J., Fuster, V., Greenstone, M., Haines, A., Hanrahan, D., … Zhong, M. (2018). The Lancet Commission on pollution and health. Lancet (London, England), 391(10119), 462–512. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32345-0/fulltext
Project Drawdown. (2020a). Bicycle Infrastructure. https://www.drawdown.org/solutions/bicycle-infrastructure
Project Drawdown. (2020b). Electric Bicycles. https://www.drawdown.org/solutions/electric-bicycles
Project Drawdown. (2020c). Walkable Cities. https://www.drawdown.org/solutions/walkable-cities
Project Drawdown. (2020d). Carpooling. https://www.drawdown.org/solutions/carpooling
Project Drawdown. (2020e). Public Transit. https://www.drawdown.org/solutions/public-transit
Project Drawdown. (2020f). Telepresence. https://www.drawdown.org/solutions/telepresence
Urban Land Institute (2010). Land Use and Driving: The Role Compact Development Can Play in Reducing Greenhouse Gas Emissions. https://uli.org/wp-content/uploads/ULI-Documents/Land-Use-and-Driving-Low-Res.pdf
World Health Organization. (2016). Global strategic directions for strengthening nursing and midwifery: 2016–2020. https://www.who.int/hrh/nursing_midwifery/global-strategic-midwifery2016-2020.pdf
Explore CANE’s work in these five key areas in support of this campaign: