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Patterson R, de Oliveira C, Schneider IJC, Mindell JS, Panter J, Laverty AA. Public transport use and mortality among older adults in England: A cohort study. Prev Med 2024; 186:108064. [PMID: 38977204 DOI: 10.1016/j.ypmed.2024.108064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 06/17/2024] [Accepted: 07/05/2024] [Indexed: 07/10/2024]
Abstract
BACKGROUND Most evidence on transport use and mortality has focused on the commute to work. This study aims to fill a gap by assessing relationships between public transport use and mortality among older adults. METHODS Data come from a cohort of 10,186 individuals aged 50 or older who participated in the English Longitudinal Study of Ageing (ELSA), with survey data linked to mortality records over 16 years (2002-2018). We assessed a binary measure of public transport use and frequency of use from 'every day or nearly every day' to 'never'. Cox proportional-hazards regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for associations between public transport use and mortality. Analyses were adjusted for a range of covariates including socio-demographic factors, chronic disease, and self-reported problems with daily living activities. RESULTS Overall, 3371 participants (33.1%) died within the study period. Mortality was lower among public transport users (21.3%) compared with non-users (64.2%). Adjusted analyses found that users had 34% lower mortality than non-users (HR 0.66 (95% CI 0.61;0.71)). Adjusted analyses showed similar association sizes across frequencies of public transport use, with those using public transport every day or nearly every day having 41% lower mortality than never users (HR 0.59 (0.49;0.71)). Associations were similar among those with and without a longstanding illness. CONCLUSION The use of public transport among older adults is linked to lower levels of mortality. Reductions in provision of public transport services could be detrimental to both transportation and population health.
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Affiliation(s)
| | - Cesar de Oliveira
- Research Department of Epidemiology and Public Health, University College London, United Kingdom
| | | | - Jennifer S Mindell
- Research Department of Epidemiology and Public Health, University College London, United Kingdom
| | - Jenna Panter
- MRC Epidemiology Unit, University of Cambridge, United Kingdom
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, United Kingdom.
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Sharman MJ, Stanesby O, Jose KA, Greaves S, Cleland VJ. Free bus fares, bus use and physical activity: An exploratory cross-sectional study. Health Promot J Austr 2024. [PMID: 38812377 DOI: 10.1002/hpja.881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/25/2024] [Accepted: 05/14/2024] [Indexed: 05/31/2024] Open
Abstract
ISSUE ADDRESSED Public transport (PT) users often accumulate more physical activity (PA) than private motor vehicle users and financial incentives may increase PT use. Responding to rising petrol prices, from 28 March to 1 May 2022, the Tasmanian government made public bus use fare-free. This exploratory study examined the perceived impact of fare-free buses on bus use and PA. METHODS Tasmanian adults who had used the fare-free buses (N = 548) completed an online survey (4 May-14 June 2022). Quantitative data were analysed using descriptive and inferential methods and responses to open-ended questions categorised. RESULTS Over the fare-free period, 46% of participants reported more bus use-average weekly bus trips increased from 3.0 to 4.0 (p < 0.001). Most (81%) participants, including 36% (n = 33/93) who were not previous bus users, planned continued bus use despite financial cost. Total PA was reported higher (36%), the same (60%) and lower (4%) than usual during the fare-free period. Higher total PA was more common amongst those reporting increased bus use (n = 186/240; 78%). Responses to open-ended questions revealed: bus use-related PA gain was through walking to/from bus stops, more frequently attending PA settings (e.g., the gym) and unexpected walking due to bus service limitations; household-level cost savings, improved travel opportunities and better social/mental health were additional fare-free benefits. CONCLUSIONS/SO WHAT Fare-free buses were commonly perceived to increase bus use and PA. Intervention studies would determine if PA and financially incentivised PT have a causal relationship. Individual- and societal-level health economic analysis of free PT is warranted.
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Affiliation(s)
- Melanie J Sharman
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Oliver Stanesby
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Kim A Jose
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Stephen Greaves
- Institute of Transport and Logistic Studies, The University of Sydney, Sydney, New South Wales, Australia
| | - Verity J Cleland
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Twardzik E, Falvey JR, Clarke PJ, Freedman VA, Schrack JA. Public transit stop density is associated with walking for exercise among a national sample of older adults. BMC Geriatr 2023; 23:596. [PMID: 37752411 PMCID: PMC10521449 DOI: 10.1186/s12877-023-04253-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Walking is the primary and preferred mode of exercise for older adults. Walking to and from public transit stops may support older adults in achieving exercise goals. This study examined whether density of neighborhood public transit stops was associated with walking for exercise among older adults. METHODS 2018 National Health and Aging Trends Study (NHATS) data were linked with the 2018 National Neighborhood Data Archive, which reported density of public transit stops (stops/mile2) within participants' neighborhood, defined using census tract boundaries. Walking for exercise in the last month was self-reported. The extent to which self-reported public transit use mediated the relationship between density of neighborhood public transit stops and walking for exercise was examined. Covariates included sociodemographic characteristics, economic status, disability status, and neighborhood attributes. National estimates were calculated using NHATS analytic survey weights. RESULTS Among 4,836 respondents with complete data, 39.7% lived in a census tract with at least one neighborhood public transit stop and 8.5% were public transit users. The odds of walking for exercise were 32% higher (OR = 1.32; 95% confidence interval: 1.08, 1.61) among respondents living in a neighborhood with > 10 transit stops per mile compared to living in a neighborhood without any public transit stops documented. Self-reported public transit use mediated 24% of the association between density of neighborhood public transit stops and walking for exercise. CONCLUSIONS Density of neighborhood public transit stops was associated with walking for exercise, with a substantial portion of the association mediated by self-reported public transit use. Increasing public transit stop availability within neighborhoods may contribute to active aging among older adults.
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Affiliation(s)
- Erica Twardzik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2024 E Monument Street, Suite 2-700, Baltimore, MD, 21205, USA.
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Jason R Falvey
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Philippa J Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Vicki A Freedman
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2024 E Monument Street, Suite 2-700, Baltimore, MD, 21205, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
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Glasson L, Panter J, Ogilvie D, Patterson R. The physical activity implications of retirement across occupational activity groups. Prev Med 2023; 173:107570. [PMID: 37315902 PMCID: PMC7614714 DOI: 10.1016/j.ypmed.2023.107570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/12/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023]
Abstract
Retirement is an important later life transition which may represent a critical period for physical activity in older age. Past findings on the association between retirement and physical activity are inconclusive and there is some evidence that the physical activity implications of retirement may differ by occupational activity level. This study used data from waves 4-9 (June 2008-July 2019) of the English Longitudinal Study on Aging to evaluate whether there is an association between retirement and physical activity, and whether this varies across occupational activity groups. Retirement was associated with a significant increase in physical activity (n = 10,693; β: 0.602 METhrs/wk. [95% CI: 0.490, 0.713], p < 0.001). There were significant interactions between retirement and past occupational activity level (n = 5109; X2 (3)=32.59, p < 0.001), such that people retiring from sedentary or standing occupations experienced a significant increase in physical activity with retirement but retirement from an occupation involving heavy manual labour was associated with a decrease in physical activity. This study quantified the importance of retirement for later life physical activity. With demographic aging, the population health importance of later life physical activity will likely become more important. These findings should inform the design of public health interventions to increase physical activity around the retirement transition.
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Affiliation(s)
- Leonie Glasson
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
| | - Jenna Panter
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - David Ogilvie
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Richard Patterson
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
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Tamura M, Tomoki I, Matsumoto K, Hattori S. Association between choices of transportation means and instrumental activities of daily living: observational cohort study of community-dwelling older adults. BMC Public Health 2023; 23:175. [PMID: 36698162 PMCID: PMC9878886 DOI: 10.1186/s12889-022-14671-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 11/18/2022] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION The association between the physical health of older people and the frequency of going out has been reported, and in recent years, local governments have developed transportation support programs for older people. Although previous studies show an association between the frequency of going out and functional health status, little has been reported on the impact of the choice of means of transport on instrumental activities of daily living (IADL). OBJECTIVE To evaluate the association between choice of transportation means and the risk of decline in IADL among older adults. METHODS We conducted an observational, population (community-dwelling)-based cohort study using data from the Resident Health Status Survey, and longitudinal panel data at 2-time points in 2016 and 2019. In addition, we combined this panel data and a database on people who were certified as requiring long-term care to identify participants' IADL. The propensity score matching method was used to classify the respondents into two groups, "active means of transportation" and "passive means of transportation," and determine the risk of a decline in means-tested independence after 3 years. RESULTS Active means were used by 6,280 (76.2%) and passive means were used by 1,865 (22.6%). 999 (12.1%) individuals declined in IADL in 2019. The results of the comparison by balancing the attributes of "active means of transportation" and "passive means of transportation," with propensity score matching, showed that "passive means of transportation" were more likely to be "active" than "passive means of transportation," and "active" was more likely to be "passive" The risk of IADL decline was significantly higher than that of "active means of transportation" with an RR of 1.93 (95% CI: 1.62-2.30). CONCLUSION Passive means of transportation in older adults could be a possible risk for decreasing IADL 3 years later. Increasing the number of opportunities and places in the community for older adults to use active means of transportation may be effective in encouraging socially independent living among older adults.
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Affiliation(s)
- Motoki Tamura
- grid.488900.dInstitute for Health Economics and Policy, Tokyu Toranomon Bldg, 1-21-19 Toranomon, Minato-ku, Tokyo 105-0001 Japan ,grid.136304.30000 0004 0370 1101Chiba University Center for Preventive Medicine, 1-33, Yayoicho, Inage-ku, Chiba Prefecture Chiba, 263-8522 Japan
| | - Ishikawa Tomoki
- grid.488900.dInstitute for Health Economics and Policy, Tokyu Toranomon Bldg, 1-21-19 Toranomon, Minato-ku, Tokyo 105-0001 Japan
| | - Komaki Matsumoto
- grid.488900.dInstitute for Health Economics and Policy, Tokyu Toranomon Bldg, 1-21-19 Toranomon, Minato-ku, Tokyo 105-0001 Japan ,Toyoake City Office, Citizens Collaboration Div., 1-1 Komochimatsu, Shindencho, Toyoake, Aichi Prefecture 470-1195 Japan
| | - Shinji Hattori
- Institute for Health Economics and Policy, Tokyu Toranomon Bldg, 1-21-19 Toranomon, Minato-ku, Tokyo, 105-0001, Japan. .,Chiba University Center for Preventive Medicine, 1-33, Yayoicho, Inage-ku, Chiba Prefecture, Chiba, 263-8522, Japan.
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Trading-Off Transit and Non-Transit Physical Activity among Older People: Evidence from Longitudinal Accelerometer Data of a Natural Experiment Study. J Urban Health 2023; 100:408-417. [PMID: 36656439 PMCID: PMC9851589 DOI: 10.1007/s11524-022-00709-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/20/2023]
Abstract
This study used a natural experiment of a new metro line in Hong Kong to examine trade-offs between transit-related and non-transit-related physical activity (PA) among 104 older people (aged ≥ 65 years) based on longitudinal accelerometer data that distinguished transit-related and non-transit-related PA. Difference-in-difference (DID) analysis compared PA changes between treatment and control groups. We found that new metro stations have trade-off effects between transit and non-transit PA. After opening metro stations, transit-related PA increased by 12 min per day on average, but non-transit-related PA decreased by 18 min per day. In addition, the proportion of time spent in transit-related PA increased by 6%. The results suggested that new metro stations could generate transit-related PA, but it might shift from non-transit-related PA among older people. Our findings revealed trade-off effects of public transit interventions and have significant implications for transport and healthy ageing studies.
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Rambaldini‐Gooding D, Molloy L, Parrish A, Strahilevitz M, Clarke R, Perez P. Free public transport and older people: An ethnographic study of an Australian bus service. Australas J Ageing 2022. [DOI: 10.1111/ajag.13158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/04/2022] [Accepted: 11/03/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Luke Molloy
- School of Nursing University of Wollongong Wollongong New South Wales Australia
| | - Anne‐Maree Parrish
- School of Health and Society University of Wollongong Wollongong New South Wales Australia
| | - Michal Strahilevitz
- School of Economics and Business Administration St. Mary's College of California Moraga California USA
| | - Rodney Clarke
- School of Management, Operations and Marketing University of Wollongong Wollongong New South Wales Australia
| | - Pascal Perez
- SMART Infrastructure Facility University of Wollongong Wollongong New South Wales Australia
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Philbrick G, Sheridan NF, McCauley K. An exploration of New Zealand mental health nurses' personal physical activities. Int J Ment Health Nurs 2022; 31:625-638. [PMID: 35166003 PMCID: PMC9305261 DOI: 10.1111/inm.12981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/25/2021] [Accepted: 01/23/2022] [Indexed: 12/26/2022]
Abstract
This study assessed the physical activities of Mental Health Nurses (MHN) in New Zealand against the 2018 World Health Organization recommended minimum levels of moderate-to-vigorous physical activity. The research design was exploratory and descriptive as there were no previous studies about physical activity levels of MHNs in New Zealand. Quantitative and qualitative data were collected using the International Physical Activity Questionnaire (IPAQ, Long Version) which included options for free-text responses. Data were analysed using descriptive and inferential statistics. A total of 266 participants returned the survey, a response rate of 4%, and a limitation of the study. More than 50% of MHNs reported <150 min of moderate-to-vigorous exercise per week for each of the four physical activity domains. When individual physical activity domains were combined, only 10% spent <150 min on moderate-to-vigorous physical activity. Work-related physical activities were higher for those working in the inpatient area than in community settings. Transport-related physical activities were higher for those working in community settings. Participants registered from 6 to 20 years had more time sitting than other groups. Nurses aged 55 years and above showed the highest total physical activity levels. Moreover, healthcare organizations and nurse leaders need to promote physical activity and provide wellness intervention for their staff. Nurses who are physically active may be more effective in supporting their patients to increase their physical activity.
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Affiliation(s)
- Glen Philbrick
- School of Nursing, Massey University, Wellington, New Zealand
| | | | - Kay McCauley
- School of Nursing, Massey University, Wellington, New Zealand
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Drivers to Obesity-A Study of the Association between Time Spent Commuting Daily and Obesity in the Nepean Blue Mountains Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010410. [PMID: 35010670 PMCID: PMC8744747 DOI: 10.3390/ijerph19010410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/20/2021] [Accepted: 12/24/2021] [Indexed: 12/29/2022]
Abstract
Obesity has become a public health challenge in every country on this planet, with a substantial contribution to global mortality and morbidity. Studies of the built environment have shown some promise in understanding the drivers of this obesity pandemic. This paper contributes to this knowledge, by focusing on one aspect of the urban environment and asking whether there is an association between commuting and obesity in residents of the Nepean Blue Mountains area on the fringes of Sydney. This is a cross-sectional study with obesity being the dependent variable, and commuting the independent variable, where 45 min or less was defined as local and distant commute was more than 45 min. In the sample of 158 respondents, the risk of obesity was twice as likely in the distant commuters than in the local commuters (OR 2.04, 95% CI 1.051 to 3.962, p = 0.034). Investigation of possible mediators of this association was limited by sample size; however, mode of transport was found to be a significant mediator. The results support the design of cities to provide health supporting environments for all residents, including equitable access to employment at a reasonable distance and effective public transport.
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10
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Mobility impact and well-being in later life: A multidisciplinary systematic review. RESEARCH IN TRANSPORTATION ECONOMICS 2021; 86:100975. [PMCID: PMC7547325 DOI: 10.1016/j.retrec.2020.100975] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/19/2020] [Accepted: 10/02/2020] [Indexed: 06/01/2023]
Abstract
In modern societies, the understanding of how active mobility affects the elderly's psycho-physical well-being is crucial to design ageing-friendly transport measures. From a multidisciplinary perspective, this systematic review points out the mobility impact on three elements of the EU Active Ageing Index: health, independence and social connectedness. By scanning four databases (Scopus, Web of Science, PubMed, and TRID), 3727 peer-reviewed papers published in the last decade were found, of which 57 met the inclusion criteria. The screening process was conducted following the PRISMA protocol and registered to the database PROSPERO, while the quality assessment was done using the Mixed Methods Appraisal Tool. More than 80% of the papers showed that an active mobility prevents psycho-physical harms, while only few papers study the relation of mobility with independence and social inclusion, to reduce the need for assistance and the related public expenditures. The findings of this review give important information both to transportation researchers and policymakers and companies, underlining the need for further research as well as investments in targeted age-friendly transport systems. The Covid-19 emergency has further underlined the importance of this issue, being the elderly one of the more disadvantaged and frailer social group.
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Abstract
The transportation sector accounts for about a quarter of global greenhouse gas emissions. Previous research suggests that major life events may be “windows of opportunity” for travel behaviour change. Our scoping review examined the effects of seven events (transitions to secondary school, post-secondary studies, labour market, marriage, parenthood, retirement, and relocation) on travel behaviours. Five databases were searched (MEDLINE, APA PsycINFO, Web of Science, SportDISCUS, and ProQuest Dissertations and Theses) and 80 articles met inclusion criteria. Relocation was the most commonly examined event (with 51 studies). Findings illustrate that moving to compact neighbourhoods (with shorter commute distance/travel time, greater walkability/access to destinations) was associated with shifts towards sustainable travel modes (e.g., walking, cycling, and transit). Relocation might be particularly conducive to implementing scalable sustainable transportation interventions, as all six interventions with appropriate statistical power were effective. Entry into the labour market was generally associated with increased car use and declines in sustainable transportation. Qualitative studies suggested that attitudes towards cycling may become negative during adolescence, while attitudes towards driving improve, highlighting a need for concerted action. Evidence for other events was less consistent. Research in developing countries remain scarce and further intervention research is needed to enhance quality of evidence.
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Dabelko-Schoeny H, Fields NL, White K, Sheldon M, Ravi K, Robinson SR, Murphy IE, Jennings C. Using Community-Based Participatory Research Strategies in Age-Friendly Communities to Solve Mobility Challenges. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2020; 63:447-463. [PMID: 32458771 DOI: 10.1080/01634372.2020.1769787] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 06/11/2023]
Abstract
The number of older adults is steadily increasing in the United States and across the globe. Aging is linked to an increased risk of disability. Disabilities that limit one or more major life activities such as seeing, hearing, walking, and motor skills impact a person's ability to drive a car. Low utilization of alternative transportation by older adults and people with disabilities may put them at risk for social isolation. Social isolation is associated with a variety of negative health outcomes. While communities are challenged to create available, acceptable, accessible, adaptable and affordable mobility options, there are widely held, inaccurate biases around older adults' abilities to contribute to the development and improvement of alternative transportation options. Gerontological social workers are well-positioned to address this bias. This paper presents a case study of a large metropolitan county in the Midwest where community-based participatory research (CBPR) strategies were used to engage older residents to support the development of alternative transportation options supporting the tenets of environmental justice.
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Affiliation(s)
| | - Noelle L Fields
- School of Social Work, The University of Texas at Arlington , Arlington, Texas, USA
| | - Katie White
- Age-Friendly Communities, Columbus and Franklin County, College of Social Work, The Ohio State University , Columbus, Ohio, USA
| | - Marisa Sheldon
- Age-Friendly Communities, Columbus and Franklin County, College of Social Work, The Ohio State University , Columbus, Ohio, USA
| | - Kristen Ravi
- College of Social Work, the University of Tennessee-Knoxville , Knoxville, Tennessee, USA
| | - Sarah R Robinson
- School of Social Work, The University of Texas at Arlington , Arlington, Texas, USA
| | - Ian E Murphy
- College of Social Work, The Ohio State University , Columbus, Ohio, USA
| | - Claire Jennings
- Age-Friendly Communities, Columbus and Franklin County, College of Social Work, The Ohio State University , Columbus, Ohio, USA
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13
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Yang Y, Langellier BA, Stankov I, Purtle J, Nelson KL, Reinhard E, Van Lenthe FJ, Diez Roux AV. Public transit and depression among older adults: using agent-based models to examine plausible impacts of a free bus policy. J Epidemiol Community Health 2020; 74:875-881. [PMID: 32535549 DOI: 10.1136/jech-2019-213317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 04/15/2020] [Accepted: 05/12/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Daily transport is associated with mental health. A free bus policy (FBP) may be effective in promoting the use of public transit in older adults and be associated with reductions in depressive symptoms. METHODS We developed an agent-based model and grounded it using empirical data from England to examine the impact of an FBP on public transit use and depression among older adults. We also used the model to explore whether the impact of the FBP bus use and depression is modified by the type of income segregation or by simultaneous efforts to improve attitudes towards the bus, to reduce waiting times or to increase the cost of driving via parking fees or fuel price. RESULTS Our model suggests that improving attitudes towards the bus (eg, campaigns that promote bus use) could enhance the effect of the FBP, especially for those in proximity to public transit. Reducing wait times could also significantly magnify FPB impacts, especially in those who live in proximity to public transit. Contrary to expectation, neither fuel costs nor parking fees significantly enhanced the impact of the FBP. The impact of improving attitudes towards the bus and increasing bus frequency was more pronounced in the lower-income groups in an income segregation scenario in which destination and public transit are denser in the city centre. CONCLUSION Our results suggest that the beneficial mental health effects of an FBP for older adults can be magnified when combined with initiatives that reduce bus waiting times and increased spatial access to transit.
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Affiliation(s)
- Yong Yang
- School of Public Health, University of Memphis, Memphis, Tennessee, USA
| | - Brent A Langellier
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Ivana Stankov
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Jonathan Purtle
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Katherine L Nelson
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Erica Reinhard
- Department of Global Health and Social Medicine, School of Global Affairs, King's College London, London, UK
| | - Frank J Van Lenthe
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
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14
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Pesola AJ, Hakala P, Berg P, Ramezani S, Villanueva K, Tuuva-Hongisto S, Ronkainen J, Laatikainen TE. Does free public transit increase physical activity and independent mobility in children? Study protocol for comparing children's activity between two Finnish towns with and without free public transit. BMC Public Health 2020; 20:342. [PMID: 32183761 PMCID: PMC7077102 DOI: 10.1186/s12889-020-8385-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 02/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children's habitual physical activity, including active travel and catching public transit (walking and cycling to and from destinations), and independent mobility (mobility without an adult) have decreased. Public transit trips are physically active and can provide access to hobbies independent of parents, but there is no device-measured data about children's total physical activity time following the introduction of free public transit. Our aim is to compare physical activity and independent mobility between children living in two Finnish towns, one with a recently introduced free public transit system, and the other without free public transit. METHODS The city of Mikkeli has provided free public transit for all comprehensive school children since 2017. Various districts from Mikkeli, and the reference town of Kouvola (towns from South-Eastern Finland with a comparative population size and geographical structure), are selected based on their accessibility and the availability of public transit services. Samples of 10-12-year-old children will be recruited through primary schools. We will compare moderate-to-vigorous physical activity time, sitting time (a thigh-worn Fibion® device) and independent mobility (a participatory mapping method, PPGIS) of children: 1) who live in towns with and without free public transit, 2) who live and go to school in districts with high vs. low perceived and objective access to free public transit, and 3) who report using vs. not using free public transit. In addition, ethnography will be used to get insights on the social and cultural effects of the free public transit on children's and parent's everyday life. DISCUSSION There is a need for scalable solutions that can increase children's physical activity independent of their socioeconomic background or place of residence. This project will give information on how a political action to provide free public transit for children is associated with their total physical activity time and independent mobility patterns, therefore providing highly relevant information for political decision-making and for promoting independent physical activity in children.
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Affiliation(s)
- Arto J Pesola
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Raviradantie 22b, 50100, Mikkeli, Finland.
| | - Pirjo Hakala
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Raviradantie 22b, 50100, Mikkeli, Finland
| | - Päivi Berg
- Juvenia - Youth Research and Development Centre, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland
| | - Samira Ramezani
- Department of Built Environment, Aalto University, Espoo, Finland
| | - Karen Villanueva
- Centre for Urban Research, School of Global Urban and Social Studies, RMIT University, Melbourne, Victoria, 3000, Australia
| | - Sari Tuuva-Hongisto
- Juvenia - Youth Research and Development Centre, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland
| | - Jussi Ronkainen
- Juvenia - Youth Research and Development Centre, South-Eastern Finland University of Applied Sciences, Mikkeli, Finland
| | - Tiina E Laatikainen
- Active Life Lab, South-Eastern Finland University of Applied Sciences, Raviradantie 22b, 50100, Mikkeli, Finland
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Liu Y, Tao L, Zhang J, Liu J, Li H, Liu X, Luo Y, Zhang J, Wang W, Guo X. Impact of Commuting Mode on Obesity Among a Working Population in Beijing, China: Adjusting for Air Pollution. Diabetes Metab Syndr Obes 2020; 13:3959-3968. [PMID: 33122932 PMCID: PMC7591004 DOI: 10.2147/dmso.s265537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/16/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Few studies have considered the interplay between commuting mode and air pollution on obesity. The aim of this study was to examine whether workplace air pollutants exposure modifying the associations between different commuting mode and obesity. METHODS A cross-sectional study of workers in Beijing was conducted in 2016. The study sample comprised 10,524 participants aged 18 to 65 years old. Outcomes were defined as overall obesity (BMI≥ 28 kg/m2) and abdominal obesity (WC ≥ 85 cm in men and WC ≥ 80 cm in women). Commuting modes were divided into walking, cycling, bus, subway, and car or taxi. Logistic regression models were used to estimate odds ratios relating commuting mode to overall and abdominal obesity and stratified by gender, controlling for covariates. RESULTS The association between commuting mode and obesity was more strongly in men than women. In the fully adjusted models, compared with car or taxi commuters, cycling (men: OR=0.37, 95% CI=0.20 to 0.68) or bus (men: OR=0.58, 95% CI=0.36 to 0.94) counterparts had a lower risk of overall obesity. Compared with car or taxi commuters, walking (men: OR=0.57, 95% CI=0.36 to 0.91), bus (men: OR=0.59, 95% CI=0.39 to 0.89), or subway (men: OR=0.59, 95% CI=0.39 to 0.89) counterparts had a lower risk of abdominal obesity. We observed significant interactions between exposure PM10 and cycling on overall obesity in men. After adjusting for air pollutants, the association between commuting mode and obesity was slightly strengthened. CONCLUSION This study findings indicate that active (walking or cycling) or public (bus or subway) commuting modes were protected factors for overall and abdominal obesity among men. Air pollutants do not obscure the benefits of active or public commuting for obesity. These associations support the policy for increasing active or public commuting as a strategy to reduce the prevalence of obesity.
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Affiliation(s)
- Yue Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Jie Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Jia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Haibin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
| | - Jingbo Zhang
- Beijing Physical Examination Center, Beijing, People’s Republic of China
| | - Wei Wang
- Global Health and Genomics, School of Medical Sciences and Health, Edith Cowan University, Perth, Western Australia, Australia
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, People’s Republic of China
- Correspondence: Xiuhua Guo Email
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Kuwahara K, Noma H, Nakagawa T, Honda T, Yamamoto S, Hayashi T, Mizoue T. Association of changes in commute mode with body mass index and visceral adiposity: a longitudinal study. Int J Behav Nutr Phys Act 2019; 16:101. [PMID: 31694716 PMCID: PMC6836489 DOI: 10.1186/s12966-019-0870-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/22/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Prospective data are sparse for active commuting to work and body weight in Asia. We assessed the association of 5-year changes in commuting mode with body mass index (BMI) and the indicators of abdominal obesity in Japanese working adults. METHODS In this longitudinal study, we studied 29,758 participants (25,808 men and 3950 women) in Japan aged 30 to 64 years at baseline who underwent further health examination 5 years after the baseline examination. Changes in BMI were calculated from objectively measured body height and weight at baseline and follow-up examination. Visceral and subcutaneous fat areas and waist circumference measured by computed tomography scans were used as indicators for abdominal adiposity. Linear regression was applied to estimate the association of changes in commuting mode with the obesity outcomes. RESULTS Within the 5-year study period, adults who maintained inactive commuting gained weight, and compared with this group, adults who switched to inactive commuting had higher weight gain; conversely, adults who switched to active or public transportation commuting and especially those who maintained active or public transportation commuting experienced less weight gain. Subgroup analysis showed similar tendency across the different transitions of leisure-time exercise or occupational physical activity. For example, among adults who maintained no exercise (n = 16,087), the adjusted mean (95% confidence intervals) of the BMI change over 5 years in kg/m2 were 0.27 (0.24 to 0.30) for maintained inactive commuting group (reference), 0.34 (0.30 to 0.38) for switching to inactive commuting group (P = 0.046), 0.20 (0.18 to 0.22) for switching to active commuting or public transportation group (P = 0.001), and 0.09 (0.06 to 0.13) for maintained active commuting or public transportation group (P < 0.001). Maintained inactive commuting tended to be associated with larger gain in abdominal adiposity indicators. CONCLUSION Switching from inactive commuting mode to more physically active commuting mode and maintaining active commuting can promote body weight control among working adults across different levels of occupational or leisure-time physical activity.
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Affiliation(s)
- Keisuke Kuwahara
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan. .,Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
| | - Hisashi Noma
- The Institute of Statistical Mathematics, Tokyo, Japan
| | - Tohru Nakagawa
- Hitachi Health Care Center, Hitachi, Ltd, Ibaraki, Japan
| | - Toru Honda
- Hitachi Health Care Center, Hitachi, Ltd, Ibaraki, Japan
| | | | | | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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