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Nieuwenhuijsen MJ. New urban models for more sustainable, liveable and healthier cities post covid19; reducing air pollution, noise and heat island effects and increasing green space and physical activity. ENVIRONMENT INTERNATIONAL 2021; 157:106850. [PMID: 34531034 PMCID: PMC8457623 DOI: 10.1016/j.envint.2021.106850] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/17/2021] [Accepted: 08/24/2021] [Indexed: 05/26/2023]
Abstract
Cities are centres of innovation and wealth creation, but also hotspots of air pollution and noise, heat island effects and lack of green space, which are all detrimental to human health. They are also hotspots of COVID19. COVID19 has led to a rethink of urban public space. Therefore, is it time to re-think our urban models and reduce the health burden? We provide a narrative meta-review around a number of cutting edge and visionary urban models that that may affect health and that have been reported over the past few years. New urban concepts such as the Superblocks, the low traffic neighbourhood, 15 Minute city, Car free city or a mixture of these that may go some way in reducing the health burden related to current urban and transport practices. They will reduce air pollution and noise, heat island effects and increase green space and physical activity levels. What is still lacking though is a thorough evaluation of the effectiveness and acceptability of the schemes and the impacts on not only health, but also liveability and sustainability, although they are expected to be positive. Finally, the COVID19 pandemic may accelerate these developments and stimulus funding like the EU Next Generation funding should be used to make these changes.
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Affiliation(s)
- Mark J Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Mary MacKillop Institute for Health Research, Melbourne, Australia.
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Bukovetz J, Shuntova K, Spiroski I, Memeti S. Assessment of health and economic benefits of walking in the Republic of North Macedonia using Health Economic Assessment Tool (HEAT). Arch Public Health 2021. [DOI: 10.3889/aph.2021.6010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Walking as a form of physical activity has immense health benefits, but it also has economic benefits. Walking is a very efficient activity that prevents certain diseases and enables better quality of life of people who already have some disease.A considerable contribution of walking is detected in cardiovascular diseases, type 2 diabetes, obesity and chronic pulmonary diseases.The aim of this study was to make a health and economic assessment of the benefits of walking in the Republic of North Macedonia by using the Health and Economic Assessment Tool (HEAT).Materials and methods:Health Economic Assessment Tool is a relatively new tool, developed by WHO experts whose expertise is in the field of Public health and is able to calculate the health effects of regular walking and/or cycling. This study was based on using this tool for walking mode for the first time in the Republic of North Macedonia in a population group of 191 participants between the age of 20 to 73 years, with the average age of 35 years.Results:Besides the aforementioned health benefits, HEAT calculates the economic benefits of walking. The tool applied to 191 participants resulted in a total economic value of 108 808.8€ for one yearas well as reduction in mortality rate. Conclusion: We found that less than one fifth of our assessed population spends time in walking according to the WHO, CDC and AHA recommendations. The rest of them, more than four fifths are not following these recommendations. Our assessed population was relatively young, the average age being 35 years old, and the population was healthy, but still the results from this survey were not satisfying.
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Mueller N, Rojas-Rueda D, Cole-Hunter T, de Nazelle A, Dons E, Gerike R, Götschi T, Int Panis L, Kahlmeier S, Nieuwenhuijsen M. Health impact assessment of active transportation: A systematic review. Prev Med 2015; 76:103-14. [PMID: 25900805 DOI: 10.1016/j.ypmed.2015.04.010] [Citation(s) in RCA: 274] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 04/11/2015] [Accepted: 04/14/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Walking and cycling for transportation (i.e. active transportation, AT), provide substantial health benefits from increased physical activity (PA). However, risks of injury from exposure to motorized traffic and their emissions (i.e. air pollution) exist. The objective was to systematically review studies conducting health impact assessment (HIA) of a mode shift to AT on grounds of associated health benefits and risks. METHODS Systematic database searches of MEDLINE, Web of Science and Transportation Research International Documentation were performed by two independent researchers, augmented by bibliographic review, internet searches and expert consultation to identify peer-reviewed studies from inception to December 2014. RESULTS Thirty studies were included, originating predominantly from Europe, but also the United States, Australia and New Zealand. They compromised of mostly HIA approaches of comparative risk assessment and cost-benefit analysis. Estimated health benefit-risk or benefit-cost ratios of a mode shift to AT ranged between -2 and 360 (median=9). Effects of increased PA contributed the most to estimated health benefits, which strongly outweighed detrimental effects of traffic incidents and air pollution exposure on health. CONCLUSION Despite different HIA methodologies being applied with distinctive assumptions on key parameters, AT can provide substantial net health benefits, irrespective of geographical context.
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Affiliation(s)
- Natalie Mueller
- Centre for Research in Environmental Epidemiology (CREAL), C/Dr. Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), C/Dr. Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), C/Monforte de Lemos 3-5, 28029 Madrid, Spain.
| | - David Rojas-Rueda
- Centre for Research in Environmental Epidemiology (CREAL), C/Dr. Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), C/Dr. Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), C/Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Tom Cole-Hunter
- Centre for Research in Environmental Epidemiology (CREAL), C/Dr. Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), C/Dr. Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), C/Monforte de Lemos 3-5, 28029 Madrid, Spain
| | - Audrey de Nazelle
- Centre for Environmental Policy, Imperial College London, Exhibition Road, South Kensington Campus, SW7 2AZ London, United Kingdom
| | - Evi Dons
- Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; Centre for Environmental Sciences, Hasselt University, Agoralaan building D, 3590 Diepenbeek, Belgium
| | - Regine Gerike
- University of Natural Resources and Life Sciences Vienna, Institute for Transport Studies, Peter-Jordan-Straße 82, 1190 Vienna, Austria
| | - Thomas Götschi
- Physical Activity and Health Unit, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Seilergraben 49, 8001 Zurich, Switzerland
| | - Luc Int Panis
- Flemish Institute for Technological Research (VITO), Boeretang 200, 2400 Mol, Belgium; School for Mobility, Hasselt University, Wetenschapspark, 3590 Diepenbeek, Belgium
| | - Sonja Kahlmeier
- Physical Activity and Health Unit, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Seilergraben 49, 8001 Zurich, Switzerland
| | - Mark Nieuwenhuijsen
- Centre for Research in Environmental Epidemiology (CREAL), C/Dr. Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), C/Dr. Aiguader 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), C/Monforte de Lemos 3-5, 28029 Madrid, Spain
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Peiró-Pérez R, Salas D, Vallés G, Abad-Fernandez MS, Vidal C, Sanchez-Contador Escudero C, Ascunce-Elizaga N, Zubizarreta R, Pedraz C, Pérez-Gómez B, Navarrete-Muñoz EM, Vioque J, Pollán M. Walking, biking or sport: how Spanish women attending breast cancer screening meet physical activity recommendations? Eur J Public Health 2015; 25:857-63. [PMID: 25767095 DOI: 10.1093/eurpub/cku248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The aim is to analyse physical activity (PA), the fulfillment recommendation of at least 150 min of moderate PA, through walking/biking (W&B), sport, both types of PA and the factors associated with inactivity by Spanish women who attended breast cancer screening programmes. METHODS The DDM-Spain is a multicentre cross-sectional study involving 3584 women, aged 45-68, attending screening in seven Spanish cities. Data were collected using a questionnaire, including age, socio-demographic and lifestyle characteristics, family burden and PA. PA was converted into metabolic equivalent of task (METs), categorized as low ≤ 600 METs min per week (m/w), moderate 600-3000 METs m/w and high ≥ 3000 METs m/w. A multivariate logistic regression was performed to identify variables associated with inactivity for each type of PA. RESULTS No women achieved a high level of PA through sport. 79.2% achieved a high or moderate level of PA by W&B. Lack of sport was associated with being overweight (odds ratio OR = 1.31; 95% confidence interval CI: 1.06 to 1.62), body mass index (BMI) ≥ 30 (OR = 1.85; 95% CI: 1.44 to 2.38), smoking (OR = 1.56; 95% CI: 1.22 to 2.00) and living with a disabled person (OR = 1.64; 95% CI: 1.0 to 2.81), whereas enough sport practice was associated with higher educational or socio-economic level (SEL). Regarding W&B, inactivity was associated with BMI ≥ 30 (OR = 1.91; 95% CI: 1.49 to 2.45) and living with someone >74 (OR = 1.96; 95% CI: 1.48 to 2.58). Inactivity for both types of exercise was associated with a BMI ≥ 30 (OR = 2.13; 95% CI: 1.63 to 2.8), smoking (OR = 1.41; 95% CI: 1.09 to 1.81) and living with someone >74 (OR = 1.69; 95% CI: 1.24 to 2.28). CONCLUSIONS Family burden and BMI ≥ 30 are inversely associated with both types of PA. W&B is the most common type of PA regardless of educational and SEL.
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Affiliation(s)
- Rosana Peiró-Pérez
- 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain 2 CIBER Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain 3 Breast Cancer Screening Programme, Valencian Public Health Directorate, Valencia, Spain
| | - Dolores Salas
- 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain 3 Breast Cancer Screening Programme, Valencian Public Health Directorate, Valencia, Spain
| | - Guillermo Vallés
- 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain
| | | | - Carmen Vidal
- 5 Cancer Prevention and Control Unit, Catalan Institute of Oncology (ICO), Barcelona, Spain
| | - Carmen Sanchez-Contador Escudero
- 6 Balearic Islands Breast Cancer Screening Programme, General Directorate Public Health and Consumer Affairs, Balearic Islands, Spain
| | - Nieves Ascunce-Elizaga
- 2 CIBER Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain
| | - Raquel Zubizarreta
- 8 Galicia Breast Cancer Screening Programme, Regional Authority of Health, Galicia Regional Government, A Coruna, Spain
| | - Carmen Pedraz
- 9 Castilla-Leon Breast Cancer Screening Programme, General Directorate Public Health, Burgos, Spain
| | - Beatriz Pérez-Gómez
- 2 CIBER Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain 11 Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Eva María Navarrete-Muñoz
- 2 CIBER Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain
| | - Jesús Vioque
- 2 CIBER Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain
| | - Marina Pollán
- 2 CIBER Epidemiología y Salud Pública (CIBERESP), ISCIII, Madrid, Spain 1 Cancer and Public Health Area. Fundación Para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Valencia, Spain 11 Cancer and Environmental Epidemiology Unit, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain
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Olabarria M, Pérez K, Santamariña-Rubio E, Novoa AM, Racioppi F. Effect of neighbourhood motorization rates on walking levels. Eur J Public Health 2014; 25:740-7. [PMID: 25500264 DOI: 10.1093/eurpub/cku206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Motorized traffic may discourage people walking. This study analyses the influence of motorization on pedestrian mobility in the neighbourhoods of a European city, controlling for environmental, sociodemographic, mobility and road safety characteristics of the neighbourhood in which each trip was made. METHODS Cross-sectional ecological study using the 38 neighbourhoods of Barcelona as the unit of analysis. Mobility information was obtained from the 2006 Daily Mobility Survey. Walking rates were calculated for 32.343 men and women who made walking trips, per 1000 men and women who made trips in the 38 neighbourhoods. Data were aggregated to calculate the total number of motorized trips made in each neighbourhood. β coefficients and their confidence intervals were calculated using Poisson regression, in order to study the relationship between walking and motorization, in the different tertiles of motorization and adjusting for contextual factors and their corresponding interactions with motorization. RESULTS Levels of motorization in the neighbourhood negatively influence walking, even when environmental variables of the neighbourhood are considered. In men we observe a gradient whereby walking rates fall as motorization rises (β = -0.248; P < 0.001 and β = -0.363; P < 0.001 in the second and third quartiles of motorization, respectively). In the case of women we find that only high levels of motorization have a negative influence on the rates of women who walk. (β = -0.256; P < 0.001). CONCLUSION Motorized traffic discourages people walking. Motorization is a modifiable environment-related factor which should be taken into account when designing policies to promote safe active travel.
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Affiliation(s)
- Marta Olabarria
- 1 Agència de Salut Pública de Barcelona, Institute of Biomedical Research (IIB Sant Pau), Plaça Lesseps 1, 08023 Barcelona, Spain
| | - Katherine Pérez
- 2 Agència de Salut Pública de Barcelona, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Biomedical Research (IIB Sant Pau), Plaça Lesseps 1, 08023 Barcelona, Spain
| | - Elena Santamariña-Rubio
- 2 Agència de Salut Pública de Barcelona, CIBER Epidemiología y Salud Pública (CIBERESP), Institute of Biomedical Research (IIB Sant Pau), Plaça Lesseps 1, 08023 Barcelona, Spain
| | - Ana M Novoa
- 1 Agència de Salut Pública de Barcelona, Institute of Biomedical Research (IIB Sant Pau), Plaça Lesseps 1, 08023 Barcelona, Spain
| | - Francesca Racioppi
- 3 European Environment and Health Governance and Multisectoral Partnership., World Health Organization (WHO) Regional Office for Europe
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Active travel intervention and physical activity behaviour: an evaluation. Soc Sci Med 2014; 113:50-8. [PMID: 24836843 DOI: 10.1016/j.socscimed.2014.05.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 04/29/2014] [Accepted: 05/02/2014] [Indexed: 11/22/2022]
Abstract
A physically active lifestyle is an important contributor to individual health and well-being. The evidence linking higher physical activity levels with better levels of morbidity and mortality is well understood. Despite this, physical inactivity remains a major global risk factor for mortality and, consequently, encouraging individuals to pursue physically active lifestyles has been an integral part of public health policy in many countries. Physical activity promotion and interventions are now firmly on national health policy agendas, including policies that promote active travel such as walking and cycling. This study evaluates one such active travel initiative, the Smarter Choices, Smarter Places programme in Scotland, intended to encourage uptake of walking, cycling and the use of public transport as more active forms of travel. House to house surveys were conducted before and after the programme intervention, in May/June 2009 and 2012 (12,411 surveys in 2009 and 9542 in 2012), for the evaluation of the programme. This paper analyses the physical activity data collected, focussing on what can be inferred from the initiative with regards to adult uptake of physical activity participation and whether, for those who participated in physical activity, the initiative impacted on meeting recommended physical activity guidelines. The results suggest that the initiative impacted positively on the likelihood of physical activity participation and meeting the recommended physical activity guidelines. Individuals in the intervention areas were on average 6% more likely to meet the physical activity guidelines compared to individuals in the non intervention areas. However, the absolute prevalence of physical activity participation declined in both intervention and control areas over time. Our evaluation of this active transport initiative indicates that similar programmes may aid in contributing to achieving physical activity targets and adds to the international evidence base on the benefits of active travel interventions.
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Mayne DJ, Morgan GG, Willmore A, Rose N, Jalaludin B, Bambrick H, Bauman A. An objective index of walkability for research and planning in the Sydney metropolitan region of New South Wales, Australia: an ecological study. Int J Health Geogr 2013; 12:61. [PMID: 24365133 PMCID: PMC3877990 DOI: 10.1186/1476-072x-12-61] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 12/21/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Walkability describes the capacity of the built environment to support walking for various purposes. This paper describes the construction and validation of two objective walkability indexes for Sydney, Australia. METHODS Walkability indexes using residential density, intersection density, land use mix, with and without retail floor area ratio were calculated for 5,858 Sydney Census Collection Districts in a geographical information system. Associations between variables were evaluated using Spearman's rho (ρ). Internal consistency and factor structure of indexes were estimated with Cronbach's alpha and principal components analysis; convergent and predictive validity were measured using weighted kappa (κw) and by comparison with reported walking to work at the 2006 Australian Census using logistic regression. Spatial variation in walkability was assessed using choropleth maps and Moran's I. RESULTS A three-attribute abridged Sydney Walkability Index comprising residential density, intersection density and land use mix was constructed for all Sydney as retail floor area was only available for 5.3% of Census Collection Districts. A four-attribute full index including retail floor area ratio was calculated for 263 Census Collection Districts in the Sydney Central Business District. Abridged and full walkability index scores for these 263 areas were strongly correlated (ρ=0.93) and there was good agreement between walkability quartiles (κw=0.73). Internal consistency ranged from 0.60 to 0.71, and all index variables loaded highly on a single factor. The percentage of employed persons who walked to work increased with increasing walkability: 3.0% in low income-low walkability areas versus 7.9% in low income-high walkability areas; and 2.1% in high income-low walkability areas versus 11% in high income-high walkability areas. The adjusted odds of walking to work were 1.05 (0.96-1.15), 1.58 (1.45-1.71) and 3.02 (2.76-3.30) times higher in medium, high and very high compared to low walkability areas. Associations were similar for full and abridged indexes. CONCLUSIONS The abridged Sydney Walkability Index has predictive validity for utilitarian walking, will inform urban planning in Sydney, and will be used as an objective measure of neighbourhood walkability in a large population cohort. Abridged walkability indexes may be useful in settings where retail floor area data are unavailable.
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Affiliation(s)
- Darren J Mayne
- Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia.
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Rojas-Rueda D, de Nazelle A, Teixidó O, Nieuwenhuijsen MJ. Health impact assessment of increasing public transport and cycling use in Barcelona: a morbidity and burden of disease approach. Prev Med 2013; 57:573-9. [PMID: 23938465 DOI: 10.1016/j.ypmed.2013.07.021] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 07/01/2013] [Accepted: 07/27/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Quantify the health impacts on morbidity of reduced car trips and increased public transport and cycling trips. METHODS A health impact assessment study of morbidity outcomes related to replacing car trips in Barcelona metropolitan (3,231,458 inhabitants). Through 8 different transport scenarios, the number of cases of disease or injuries related to physical activity, particulate matter air pollution <2.5 μm (PM2.5) and traffic incidents in travelers was estimated. We also estimate PM2.5 exposure and cases of disease in the general population. RESULTS A 40% reduction in long-duration car trips substituted by public transport and cycling trips resulted in annual reductions of 127 cases of diabetes, 44 of cardiovascular diseases, 30 of dementia, 16 minor injuries, 0.14 major injuries, 11 of breast cancer and 3 of colon-cancer, amounting to a total reduction of 302 Disability Adjusted Life Years per year in travelers. The reduction in PM2.5 exposure in the general population resulted in annual reductions of 7 cases of low birth weight, 6 of preterm birth, 1 of cardiovascular disease and 1 of lower respiratory tract infection. CONCLUSIONS Transport policies to reduce car trips could produce important health benefits in terms of reduced morbidity, particularly for those who take up active transportation.
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Affiliation(s)
- D Rojas-Rueda
- Centre for Research in Environmental Epidemiology (CREAL), C. Doctor Aiguader, 88, 08003 Barcelona, Spain; Municipal Institute of Medical Research (IMIM-Hospital del Mar), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Departament de Ciències Experimentals i de la Salut, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
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Active commuting among K-12 educators: a study examining walking and biking to work. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2013; 2013:162731. [PMID: 24089620 PMCID: PMC3781922 DOI: 10.1155/2013/162731] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 08/07/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Walking and biking to work, active commuting (AC) is associated with many health benefits, though rates of AC remain low in the US. K-12 educators represent a significant portion of the workforce, and employee health and associated costs may have significant economic impact. Therefore, the purpose of this study was to examine the current rates of AC and factors associated with AC among K-12 educators. METHODS A volunteer sample of K-12 educators (n = 437) was recruited to participate in an online survey. Participants responded about AC patterns and social ecological influences on AC (individual, interpersonal, institutional, community, and environmental factors). t-tests and ANOVAs examined trends in AC, and Pearson correlations examined the relationship between AC and dependent variables. Multiple regression analysis determined the relative influence of individual, interpersonal, institutional, community, and environmental levels on AC. RESULTS Participants actively commuted 0.51 ± 1.93 times/week. There were several individual, interpersonal, institutional, community, and environmental factors significantly related to AC. The full model explained 60.8% of the variance in AC behavior. CONCLUSIONS This study provides insight on the factors that determine K-12 educators mode of commute and provide some insight for employee wellness among this population.
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Woodcock J, Givoni M, Morgan AS. Health impact modelling of active travel visions for England and Wales using an Integrated Transport and Health Impact Modelling Tool (ITHIM). PLoS One 2013; 8:e51462. [PMID: 23326315 PMCID: PMC3541403 DOI: 10.1371/journal.pone.0051462] [Citation(s) in RCA: 152] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 11/05/2012] [Indexed: 01/11/2023] Open
Abstract
Background Achieving health benefits while reducing greenhouse gas emissions from transport offers a potential policy win-win; the magnitude of potential benefits, however, is likely to vary. This study uses an Integrated Transport and Health Impact Modelling tool (ITHIM) to evaluate the health and environmental impacts of high walking and cycling transport scenarios for English and Welsh urban areas outside London. Methods Three scenarios with increased walking and cycling and lower car use were generated based upon the Visions 2030 Walking and Cycling project. Changes to carbon dioxide emissions were estimated by environmental modelling. Health impact assessment modelling was used to estimate changes in Disability Adjusted Life Years (DALYs) resulting from changes in exposure to air pollution, road traffic injury risk, and physical activity. We compare the findings of the model with results generated using the World Health Organization's Health Economic Assessment of Transport (HEAT) tools. Results This study found considerable reductions in disease burden under all three scenarios, with the largest health benefits attributed to reductions in ischemic heart disease. The pathways that produced the largest benefits were, in order, physical activity, road traffic injuries, and air pollution. The choice of dose response relationship for physical activity had a large impact on the size of the benefits. Modelling the impact on all-cause mortality rather than through individual diseases suggested larger benefits. Using the best available evidence we found fewer road traffic injuries for all scenarios compared with baseline but alternative assumptions suggested potential increases. Conclusions Methods to estimate the health impacts from transport related physical activity and injury risk are in their infancy; this study has demonstrated an integration of transport and health impact modelling approaches. The findings add to the case for a move from car transport to walking and cycling, and have implications for empirical and modelling research.
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Affiliation(s)
- James Woodcock
- UKCRC Centre for Diet and Activity Research (CEDAR), Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
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