Sitting in the driver’s seat – by Krishma Caleyachetty

A bus driver rubs his hand down from his forehead and over his eyes, as he patiently listens to my questions. I ask if he thought he ate a healthy diet and if he did any physical activity. He scans the horizon before catching my gaze, revealing that he doesn’t have breakfast because he has to be out the door by 4am. He describes when he is too exhausted after work, to do anything more than just sit on his sofa and have dinner, before falling into bed. He has been trying to eat better for some time now, he’d tell me later, but life at the moment was too busy and stressful.

On this brisk May morning in South London, I sit across the table from several drivers. With each driver, I individually talk through the Type 2 Diabetes Know Your Risk Tool, trying to explain the difference between the risk factors they can’t change but should be aware of, and those they can.

Bus drivers face risk of developing diabetes

For many of these bus drivers, the risk of developing diabetes asserts a looming presence. But this is not something new to them. GPs have told them before to lose weight, or they know of family members with the condition. Over the course of my visits to the bus garages, I realise the compounding effects on the health of drivers, from long working hours remaining seated, shifting schedules and dealing with the strain of driving many miles. I heard frequently about their stressful lives, and where some even lacked the time to spend with their children, let alone go to the gym or for a run.

Not long ago, I started my new role in the Engaging Communities team at Diabetes UK, working to support Community Champions improve diabetes prevention and self-management in Black, Asian and Minority Ethnic (BAME) communities, who are two to four times more likely to develop type 2 diabetes than White Europeans.

Recently, I, alongside my team and Champions, have been visiting London bus garages, where a large percentage of drivers are from BAME backgrounds. As part of the Bus4Life project, we have been providing information on diabetes prevention and self-management, as well as conducting the risk assessments.

Bus4Life is a national project by Arriva Transport Solutions, which links to the national Change4Life campaign promoting healthy eating and physical activity, and aims to give employees a greater awareness of adopting a healthier lifestyle.

It works something like this: a bus outfitted with a height and weight machine and privacy booths for one-to-one counselling, visits a garage for the day, delivering mini health checks to drivers. Heights, weights, body fat percentages are measured, blood pressure is checked, and brief advice and health leaflets are given.

Useful as these health statistics are, perhaps it is even more useful to think about what they don’t say. Behind the numbers lie the particulars – stories of how the drivers’ daily routines have a significant impact on their health.

For decades, it has been known that bus drivers are at high risk of heart diseases, gastrointestinal illnesses, and musculoskeletal problems, compared to other occupations. This may not be surprising. Drivers are typically sitting for more than 12 hours a day, three hours longer than office workers.

Conductors half at risk of a heart attack than bus drivers

In 1949, Jerry Morris, a professor of social medicine in London, conducted a pioneering study comparing the rates of heart disease between London bus drivers and conductors. Both drivers and conductors were from similar social backgrounds; however, there was a marked difference in the rates of disease between these two groups.

Morris conducted an analysis which showed that, compared to drivers, conductors were half as likely to die from a heart attack. He also spent many hours riding buses, building a profile of the daily routines of drivers and conductors. His explanation for the bus drivers’ ailing bodies was that in a working day, while drivers were typically sedentary, conductors climbed and went down 500 to 750 steps.

Before ending my day at a garage, one driver takes me on a tour. Lockers and leaflets line the main office area. The break room is just up the stairs, looking something of a mixture between a bar and café. I’m struck by the stylised décor of the space, modern wooden furnishings and sectioned areas for dining and lounging. It’s new, I’m told.

Drivers sit together at tables chatting over lunch, while others are slumped in wide arm chairs near the television, dozing. On the far side of the room, I see a lady clearing up at the eatery many drivers had mentioned to me. It closes at 3pm, but there are vending machines to provide food at all hours. I take a walk around, noticing the baguette sandwiches, crisps and hot meals on offer.

Back in the Bus4Life bus, I sit across from a man that’s been driving for 15 years. He periodically checks his watch. I answer his questions about complex carbohydrates and “good” fats, and make recommendations for physical activity based on the details he’s shared with me. After a while he tells me he needs to get home to his wife, and thanks me for my time.

More information

If you would like to know more or have questions about the Community Champions programme, please email krishma.caleyachetty@diabetes.org.uk.

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