In the summer of 2012, Sarah Kim was cycling home on Bloor St. when a car door opened to her right, striking her handlebar. The wheel lurched left, launching her from her bike into the next lane. Dazed from the impact, she looked up to see a car approaching, the front fender at the level of her face.

In those next seconds, the hand of death passed her over: the approaching car was moving slow enough that the driver was able swerve into oncoming traffic to avoid running her over, tires screeching as panicked drivers slammed on their brakes. The car following behind the first came to a stop in front of her, a foot from her nose, filling her nostrils with exhaust.

Incredibly, no other collision occurred. She walked from the scene with a broken bike, scuffed helmet, separated shoulder and a deepened perspective on life and the lack of safe cycling infrastructure in Toronto.

As doctors, most of us spend our careers caring for people in clinical settings. Nonetheless, public health achievements are what make the most difference to our patients’ health. Clean water, sanitation, and food inspection are standard provisions by municipalities because these actions prevent illness, disability, and death. Likewise, measures to improve road safety are necessary public health interventions.

Yet, as illustrated above, to travel by bicycle is often dangerous. The main reason people give for not cycling is fear of cycling on the road with car traffic. In Toronto, more than 1,000 cyclists are injured in collisions with motor vehicles annually.

These are preventable injuries; cyclists in Europe are two to three times less likely to be injured and eight to 30 times less likely to be killed than their North American counterparts because their roads have been redesigned to accommodate people using multiple modes of transport.

Similarly within Canada, collision rates between people who bike alongside motor vehicles in Vancouver and Montreal are lower than in Toronto, despite a higher proportion of users of active transportation in those cities, because of better cycling infrastructure.

Active transportation is any form of human-powered transportation; the most common forms are walking and cycling. Most active transportation users who travel by bicycle are not professional cyclists; they are people who use bicycles to get around.

As physicians, it is too often that we are faced with irrecoverable injuries in pedestrians and cyclists involved in collisions with vehicles. Ameliorating street design can nullify inevitable human error to keep all road users safe.

We also regularly treat patients with obesity, hypertension, and diabetes: chronic diseases that can be prevented and managed through increased physical activity. Protected bike lanes foster active transportation, positively influencing the health of Canadians through safe and accessible travel for people of varying ages, fitness and ability levels.

In Toronto, Bloor St. is a major artery. The Bloor St. bike lanes began as a pilot project. These separated bike lanes are a key part of Toronto’s road safety plan. They have reduced cyclist injuries and decreased conflicts among all transportation users (including motorists and pedestrians) by 44 per cent since their installation. Bloor St. is now the second most used bikeway in the city, with more than 5,200 cyclists using it daily. Currently, 85 per cent of cyclists feel “safe” compared to 3 per cent before the bike lanes were installed.

Yet, opposition to their permanence still exists. Road safety is a public health priority and municipalities are accountable for the health and well-being of all who use the roads. It is their responsibility to provide safe cycling infrastructure for Canadian communities.

Difficulties will arise as we move from roads designed for motor vehicles to complete streets that can be shared safely by everyone. Cultural norms take time to evolve. Such initial resistance occurred with other public health interventions, such as the indoor smoking ban and seatbelts in motor vehicles.

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As we gather knowledge to improve the health and safety of Canadians, we should not ignore the evidence and maintain status quo. As doctors, we care professionally for all of our patients. As people, we care about our families, friends and communities. We need to adapt our streets so that everyone can arrive home safely every day.

Dr. Sarah Kim, sports and exercise medicine, and Dr. Eileen Cheung, emergency medicine, are both practicing physicians based in Toronto. They are members of Doctors for Safe Cycling, advocating for complete streets and the mission of VisionZero in Toronto.