Introduction

Australia and New Zealand, like other developed countries, face serious health problems due to increasing levels of chronic disease such as type 2 diabetes, obesity and heart disease. The Organisation of Economic Co-operation and Development [OECD] recently reported that chronic non-communicable diseases are now the main cause of both disability and death worldwide (OECD, 2010). Globally, chronic diseases have overtaken communicable diseases and injuries as the leading burden of disease (Nugent, 2008). Of the 58 million deaths that occurred globally in 2005, approximately 35 million, or 60%, were due to chronic causes, and most of them were due to cardiovascular disorders and diabetes (32%), cancers (13%) and chronic respiratory diseases (7%) (Abegunde, Mathers, Taghreed, Ortegon, & Strong, 2007). Global projections are that levels of chronic disease will only worsen in coming years (Nugent, 2008; Lopez, 2006). This chapter describes the chronic disease challenges facing developed countries such as Australia and New Zealand and critically examines the evidence that cycling can assist in addressing these challenges. It provides an overview of the international literature on the health benefits of cycling, including relevant Australian studies. It discusses how Australian health promotion agencies approach health aspects of cycling.

Health challenges

In Australia, the leading underlying cause of death in 2011 was coronary heart disease, followed by lung cancer and cerebrovascular disease among men, and cerebrovascular disease and dementia and Alzheimer's disease among women (Australian Institute of Health and Welfare, 2014). Currently, 9 in 10 deaths have chronic disease as an underlying cause (AIHW, 2014). Data from the 2007-08 National Health Survey indicates that one-third of the Australian population (35%, or 7 million people) reported having at least one of the following chronic conditions: asthma, type 2 diabetes, coronary heart disease, cerebrovascular disease (mainly stroke), arthritis, osteoporosis, chronic obstructive pulmonary disease [COPD], depression or high blood pressure. In Australia and New Zealand, chronic diseases together cause 85% of the total burden of disease (Institute for Health Metrics and Evaluation [IHME], 2013). There are an estimated 1 million people with diagnosed diabetes in Australia, and the incidence of new cases is increasing rapidly, including among young people (AIHW, 2014). The rate of selfreported diabetes more than doubled between 1989-90 and 2011-12, from 1.5% to 4.2% of Australians.