National and metropolitan trends in public transit use, transit-related walking, and ridesharing between 2009 and 2017

Estimates of walking prevalence and volume for U.S. cancer survivors and those without cancer: overall, by sex, and by race and ethnicity

PURPOSE

This paper estimated overall, by sex, and by race and ethnicity walking behaviors in the cancer survivor population, where prevalence is not known, compared to those without cancer.

METHODS

Data from the 2015 and 2020 National Health Interview Survey (n = 54,542) were used to estimate walking behaviors. Multivariable logistic regression models estimated walking behavior prevalence with predictive margins and volume of weekly minutes overall and stratified by sex and race/ethnicity. Walking behaviors for breast and prostate cancer survivors were also examined.

RESULTS

There were no significant differences in adjusted prevalence for walking behaviors overall or by race/ethnicity for women. However, there were significant differences for men, with cancer survivors' any reported walking at 62.6% (95% CI: 60.1, 65.4) compared to men without cancer, 65.9% (95% CI: 65.1%, 66.8%) (p = 0.02). There was also a difference in transportation only walking for men, with cancer survivors reporting 6.8% (95% CI: 5.5%, 8.2%), compared to men without cancer, 9.1% (8.5%, 9.6%) (p = 0.008); a similar pattern was observed for transportation walking for non-Hispanic white men. There were no differences in walking prevalence among breast cancer survivors, but overall prostate cancer survivors reported less walking for both purposes as did non-Hispanic white survivors. Leisure walking volume for cancer survivors, both women and men, was higher than for those without cancer. Median leisure walking minutes for non-Hispanic white women, 120 min (95% CI: 120, 140) was higher than those without cancer, 105 min (95% CI: 105, 120) (p = 0.002). Median leisure walking minutes for non-Hispanic white men, 120 min (95% CI: 120, 140), was higher than those without cancer, 100 min (95% CI: 100, 105) (p = 0.001).

CONCLUSIONS

Overall, there are no significant differences in walking prevalence for women, but men cancer survivors reported less overall walking, walking for transportation, or walking for both purposes. However, volume of leisure walking was higher for cancer survivors compared to those without cancer.

IMPLICATIONS FOR CANCER SURVIVORS

For cancer survivors, this suggests that even though prevalence of leisure walking was similar, volume of weekly minutes was higher compared to those without cancer. This suggests that for cancer survivors, leisure walking is an accessible and important source of physical activity.

Mixed method assessment of built environment and policy responses to the COVID-19 pandemic by United States municipalities focusing on walking and bicycling actions

Introduction

In 2020, the COVID-19 pandemic prompted community officials to initiate local level environmental and policy changes to slow the spread of infection and provide more opportunities for outdoor recreation. Changes in both regards could positively or negatively impact walking and bicycling. Using a mixed methods approach, the purpose of this United States-based study was to systematically describe municipal response to the pandemic at the community level through environmental and policy changes that may have impacted walking and bicycling.

Methods

Websites of all United States' municipalities with a residential population of at least 100,000 (n = 314) were searched to identify environmental and policy changes that might impact walking/bicycling as a result of the pandemic. When actions were identified, we systematically abstracted information from the websites. To provide more contextual information, we interviewed representatives from 12 municipalities about changes made at the municipal level as a result of the pandemic that could impact walking and bicycling. Interviews were recorded, transcribed, and coded for themes.

Results

For the 314 municipalities, we identified 353 actions resulting from the COVID-19 pandemic that may impact walking and bicycling. Approximately double the number of actions were identified in large-size municipalities (234 actions in 157 municipalities with population≥165,000) compared to mid-size municipalities (119 actions among 157 municipalities with population 100,000 to 164,999). Generally, fewer actions that might suppress walking and bicycling (n = 59) were identified in comparison to actions that would likely facilitate walking and bicycling (n = 294). In-depth interviews provided further context and insight into these results.

Conclusion

This mixed-method assessment provides an overview of the environmental and policy changes which may impact walking and bicycling that municipalities implemented in 2020 due to the pandemic. A next step in this line of inquiry is to quantify the impact of these changes on population levels of walking and bicycling and related health and safety outcomes.

The 2019 Conference on Health and Active Transportation: Research Needs and Opportunities

Active transportation (AT) is widely viewed as an important target for increasing participation in aerobic physical activity and improving health, while simultaneously addressing pollution and climate change through reductions in motor vehicular emissions. In recent years, progress in increasing AT has stalled in some countries and, furthermore, the coronavirus (COVID-19) pandemic has created new AT opportunities while also exposing the barriers and health inequities related to AT for some populations. This paper describes the results of the December 2019 Conference on Health and Active Transportation (CHAT) which brought together leaders from the transportation and health disciplines. Attendees charted a course for the future around three themes: Reflecting on Innovative Practices, Building Strategic Institutional Relationships, and Identifying Research Needs and Opportunities. This paper focuses on conclusions of the Research Needs and Opportunities theme. We present a conceptual model derived from the conference sessions that considers how economic and systems analysis, evaluation of emerging technologies and policies, efforts to address inclusivity, disparities and equity along with renewed attention to messaging and communication could contribute to overcoming barriers to development and use of AT infrastructure. Specific research gaps concerning these themes are presented. We further discuss the relevance of these themes considering the pandemic. Renewed efforts at research, dissemination and implementation are needed to achieve the potential health and environmental benefits of AT and to preserve positive changes associated with the pandemic while mitigating negative ones.