Boston Doctors Now Prescribing Bike-Share Memberships

The newest tool for doctors in the fight against obesity? That’s right: Bike-share.

Doctors in Boston are now prescribing Hubway memberships. Photo: Hubway
Doctors in Boston are now prescribing Hubway memberships. Photo: Hubway

This week in Boston, doctors introduced a program called Prescribe-a-Bike, offering low-income residents struggling with obesity an annual Hubway bike sharing membership for the low price of $5. The program is being administered by Boston Medical Center in partnership with the city of Boston. Qualifying patients will have access to Hubway’s 1,100 bikes at 130 locations. Participants will also receive a free helmet.

“There is no other program like this in the country,” Mayor Marty Walsh told Boston Magazine. “Prescribe-a-Bike makes the link between health and transportation, and ensures that more residents can access the Hubway bike-share system.”

Local officials hope the program will result in about 1,000 additional memberships, according to the Boston Globe.

In the medical community this type of recommendation is known as an exercise prescription, and it is a growing practice. More doctors are prescribing exercise, the CDC says, as “lifestyle diseases” like obesity, heart disease and diabetes have become some of the leading killers in the United States. In addition, policy measures like the Affordable Care Act are providing incentives for the healthcare industry shift focus from treatment of disease to the promotion of wellness.

For a while in the last decade, one of the leaders in this movement, Kaiser Permanente, experimented with prescribing sedentary patients pedometers so that they could track their daily walking.

“Physical inactivity has become the greatest public health problem of our time,” said Dr. Robert Sallis, a leading proponent of this type of medicine, “and finding a way to get patients more active is absolutely critical to improving health and longevity in the 21st century.”

  • Kevin Love

    An important document laying out the relationship between active transportation and health is Toronto Public Health’s “The Road to Health”

    http://www.toronto.ca/health/hphe/pdf/roadtohealth.pdf

    An excerpt follows:

    Based on very conservative calculations, 2006 levels of walking and cycling in
    Toronto are estimated to prevent about 120 deaths each year. Total savings from these prevented deaths range from $130 million to $478 million depending on how deaths are valued. Savings in direct medical costs arising from residents staying active by walking and cycling are estimated to provide a further economic benefit of $110 to $160 million.

    Achieving walking and cycling commuting mode shares of 12% and 6%, respectively, would prevent about 100 additional deaths each year, yielding additional annual benefits of $100 million to $400 million.

  • Larry Littlefield

    I think this is an absolutely essential way to think about — and fund — active transportation.

    The insurance company I’m assigned to by my employer, one of the largest in the country, offers subsidies for health club memberships, but not for active transportation. Why? Because the health club can confirm that someone actually shows up. I have no such confirmation for my bike commute.

    I turned to active transportation, however, because I had the same problem most Americans have — no time, separate from work, family and community responsibilities, to go to a health club and spending 1 hour-plus extra getting there and back and exercising. The commute, or trip to the grocery or elsewhere, is the time available for exercise.

    As an analogy, when talking about the possibility of dynamic carpooling with one-person per vehicle auto commuters, I have more than once heard long auto commutes described as a blessing rather than a burden. “That’s my ‘me time’ when I can decompress.” Same thing. The bike commute is my “me time,” but I’m getting exercise.

    The key here isn’t bike share per se, but the tracking technologies the bike share systems have had to come up with. In theory, those tracking systems could be put on personally owned bicycles too, which could then be tracked by doctors/insurance companies. Such systems could be designed into the bicycles. While it would be possible for someone to pretend to get exercise by having someone else ride on their behalf, that isn’t much of a scam in an national sense, because SOMEONE would be riding.

    This technology raises new possibilities. I suggest that those involved in active transportation make linking the technology, the bicycle manufacturers, and the health insurance industry a priority.

  • WalkingNPR

    I’m a physician finishing up my MPH and this is exactly the topic of my thesis research. I can tell you from the work I’ve already done, nearly every company I talked to had either an onsite fitness center or subsidized gym memberships, but hardly anyone had even thought of–much less done anything about–encouraging active commuting. Several even told me they were too busy dealing with things like obesity and diabetes to address active commuting (duh!).

    There is at least one program that’s starting to do this a bit:

    https://www.derozap.com/zaptwincities/

    My understanding of it is that you put the tracker on your bike and it logs when you ride past certain stations. So it only captures people who ride past those stations, but it’s a start in the right direction.

    I’m really convinced bikeshare is the way to go with encouraging people to try bike commuting. It’s minimal investment for the bike-curious and you always have the ability to just use it one-way if you’re someone who has access to a train or bus but wants to move to even more active forms of commuting (for example, as a female arriving with hair/makeup somewhat intact is an issue for me in the morning, but I’d happily bike home in the afternoon).

  • Larry Littlefield

    It’s really the only thing that works. I used to go jogging, which I hated, before we had kids. I weigh 50 lbs more than I did then. I tried going out early in the morning, etc. It just didn’t work.

    But I’ve been in relatively good shape since I started bike commuting about seven years ago. Too bad I didn’t think to do it all along — it didn’t seem practical. Business casual, all the bike parking, all the bike lanes pushed for by those who were ahead of their time made it workable.

  • I think it’s even more important to consider that what people gain from moderate levels of exercise is also more years of quality life. From the NY Times, a study shows that people who are fit in their fifties not only live somewhat longer than those who are not, but they have significant delay of onset of chronic (and expensive) health problems. Basically if you are fit in your fifties, you get 5, 10, or even 15 extra high quality/good health years that people who are not fit in their 50’s don’t get.

    “What they found was that those adults who had been the least fit at the time of their middle-age checkup also were the most likely to have developed any of eight serious or chronic conditions early in the aging process. These include heart disease, diabetes, Alzheimer’s, and colon or lung cancer.

    “The adults who’d been the most fit in their 40s and 50s often developed many of the same conditions, but notably their maladies appeared significantly later in life than for the less fit. Typically, the most aerobically fit people lived with chronic illnesses in the final five years of their lives, instead of the final 10, 15 or even 20 years.”

    http://well.blogs.nytimes.com/2012/09/05/the-benefits-of-middle-age-fitness/

    I would guess the cost of having the vast majority of the US population grind through 10, 15 or 20 years of very poor health (doctor’s visits, medications, hospitalizations, convalescent care, etc.) is vastly higher (perhaps 100x?) than the cost of early deaths associated with lack of fitness.

  • GC

    Positive impacts to pocketbook and very often to diet as well. Sounds like a winner.

  • Cálcio Heavy Metal

    It would be implemented in many countries.