What are the health benefits of active travel? A systematic review of trials and cohort studies

Exploring the Relationship of Leisure Travel with Loneliness, Depression, and Cognitive Function in Older Adults

Loneliness, depression, and cognitive decline are pressing concerns among older adults. This study examines the association between leisure travel participation and these health outcomes in older adults, aiming to provide further evidence of the benefits of leisure travel. Using nationally representative historical data from the 2006 household survey of the Health and Retirement Study, this study conducted a series of regression analyses to investigate the relationship between traveling and the three health outcomes, adjusting for age, sex, race, marital status, education, total wealth, annual income, and difficulty with daily activities. The results reveal that travel patterns in terms of distance are significantly associated with loneliness, depression, and cognitive function. Long-distance travel is positively related to higher cognitive function and a reduction in depressive symptoms, along with lower levels of loneliness, reinforcing the notion that leisure travel can potentially act as a catalyst for improved cognitive and mental health by offering opportunities for enhancing social connections and forming new relationships. The findings on the relationships between participation in leisure travel and mental and cognitive health contribute to the body of evidence supporting the therapeutic value of leisure travel in promoting healthy aging and enhancing the overall well-being in older adults.

The ABC of mobility

The use of cars in cities has many negative impacts, including pollution, noise and the use of space. Yet, detecting factors that reduce the use of cars is a serious challenge, particularly across different regions. Here, we model the use of various modes of transport in a city by aggregating Active mobility (A), Public Transport (B) and Cars (C), expressing the modal share of a city by its ABC triplet. Data for nearly 800 cities across 61 countries is used to model car use and its relationship with city size and income. Our findings suggest that with longer distances and the congestion experienced in large cities, Active mobility and journeys by Car are less frequent, but Public Transport is more prominent. Further, income is strongly related to the use of cars. Results show that a city with twice the income has 37% more journeys by Car. Yet, there are significant differences across regions. For cities in Asia, Public Transport contributes to a substantial share of their journeys. For cities in the US, Canada, Australia, and New Zealand, most of their mobility depends on Cars, regardless of city size. In Europe, there are vast heterogeneities in their modal share, from cities with mostly Active mobility (like Utrecht) to cities where Public Transport is crucial (like Paris or London) and cities where more than two out of three of their journeys are by Car (like Rome and Manchester).

Pedestrian-oriented zoning moderates the relationship between racialized economic segregation and active travel to work, United States

OBJECTIVE

Pedestrian-oriented zoning, including zoning code reforms (ZCR), may be especially beneficial to racially and economically segregated communities, which may lack built environment features that support physical activity. This study examined associations between racialized economic segregation, measured by quintiles of the Index of Concentration at the Extremes, and public transit (PTW) and active travel (ATW) to work, and whether associations were moderated by pedestrian-oriented zoning provisions and ZCR, respectively.

METHODS

Zoning codes effective as of 2010 representing 3914 US municipalities (45.45% of US population) were evaluated for the presence of ZCR and eight pedestrian-oriented zoning provisions. These data were linked with American Community Survey 2013-2017 and NAVTEQ 2013 data on the outcomes and relevant covariates. Fractional logit regressions were computed with standard errors clustered on county.

RESULTS

Workers from more deprived quintiles were less likely to engage in PTW and ATW (OR = 0.22-0.55, p < 0.01), and tests revealed moderation by zoning (p < 0.05). ZCR was positively associated with PTW for the three most deprived quintiles (OR = 1.53-2.38, p < 0.01), and with ATW for the two most deprived quintiles (OR = 1.42-1.69, p < 0.01) and the second most privileged quintile (OR = 1.26, p < 0.05). In the most privileged quintile, the zoning scale score was negatively associated with PTW (OR = 0.91, p < 0.001) and ATW (OR = 0.94, p < 0.01). However, in the most deprived quintiles, the zoning scale score was positively associated with PTW (Q2: OR = 1.13, p < 0.01) and ATW (Q1-Q2: OR = 1.07-1.09, p < 0.05).

CONCLUSIONS

Pedestrian-oriented zoning can provide opportunities for ATW in the most deprived communities. Work is needed to explore zoning policy implementation in those communities.

University bicycle programming capacity for underrepresented student populations: Pedaling toward equitable opportunities

Purpose: Universities and colleges play a major role in facilitating the behaviors of students into adulthood. Active travel (AT; walking or bicycling for transportation) can provide substantial health benefits, though inequities among bicycling are shown in many underserved populations (racial/ethnic minorities, women, LGBTQ+, disabled, low-income). This study aimed to understand universities' capacity for underserved populations programming on campuses. Methods: Representatives from U.S. universities/colleges participated in an online survey which addressed basic information about university demographics/culture, common barriers and desired tools to reaching underserved students, priorities, and important outcomes. Results: University respondents (n = 51) indicated a lack of programming and implementation of strategies to reach underserved campus populations. Typically, universities ranked equity as a low priority and limited strategies for promoting bicycling reached/targeted underserved populations. Conclusion: There is a notable lack of programs and strategies to engage underserved populations on campus that should be addressed to better serve student health outcomes.

Success and Challenges of Community Bicycle Advocacy Organizations in Reaching Underserved Populations

INTRODUCTION

Bicycling, as forms of recreation and travel, offers many positive physical and mental health benefits, though there are still many disparities in bicycling rates among underserved populations in the United States. Community bicycling advocacy organizations/coalitions promote and advocate for increased bicycling; however, have been shown to have a lack of organizational capacity for equitable programming to diverse populations (racial/ethnic minorities, women, low-income, LGBTQ+ communities, youth). The purpose of this study was to understand the current practices for providing underserved populations bicycling programming among advocacy organizations and to find major barriers and helpful tools for equitable programming.

METHODS

This was conducted in a volunteer sample of U.S. bicycle advocacy organizations. An interview (n = 23) assessed organizational function, successful programs, and barriers to reaching underserved populations.

RESULTS

Several themes emerged from the interviews. Participants stated that the lack of organizational leadership and member diversity, along with a lack of trust with underserved communities, presented major barriers to providing equitable programming. Partnering with other community organizations that place an emphasis on serving diverse populations was noted to have potential for increasing successful programming by allocating resources and connections.

CONCLUSION

Although barriers exist for bicycle advocacy organizations when attempting to reach underserved and diverse populations, groups should focus on creating successful and diverse partnerships to increase the capacity for providing equitable programming.

Enhancing cardiometabolic health through physical activity and breakfast manipulations in children and adolescents: good for humans, good for the planet

The human health benefits of cardiometabolic disease prevention can be accompanied by planetary co-benefits. Focusing efforts towards young people, including children and adolescents, is conducive to disease prevention. In the context of cardiometabolic disease prevention, this review paper critically summarises the available literature on the acute cardiometabolic responses to physical activity and breakfast manipulations among young people. Given the seriousness of global climate change, which will disproportionally affect our younger generations, this review paper offers new insights into the inherent interactions between child-adolescent behaviour and cardiometabolic health from an environmental sustainability perspective to aid climate change mitigation efforts, including exploring future research avenues. A growing evidence base suggests acute moderate- to high-intensity exercise bouts can attenuate postprandial plasma glucose, insulin and triacylglycerol concentrations for up to 24-48 h in young people. Whether accumulating physical activity throughout the day with short, frequent bouts promotes cardiometabolic risk marker attenuations is unclear. Breakfast consumption may enhance free-living physical activity and reduce glycaemic responses to subsequent meals for a possible additive impact. If repeated habitually, attenuations in these cardiometabolic risk factors would be conducive to disease prevention, reducing the greenhouse gas emissions associated with disease diagnosis and treatment. To progress current understanding with high public health and planetary relevance, research among samples of 'at risk' young people that span cellular-level responses to ecologically valid settings and address human and planetary health co-benefits is needed. Indeed, certain physical activity opportunities, such as active travel to school, offer important direct co-benefits to humans and planetary health.

Exploring views of members of the public and policymakers on the acceptability of population level dietary and active-travel policies: a qualitative study

BACKGROUND

There is limited evidence on what shapes the acceptability of population level dietary and active-travel policies in England. This information would be useful in the decision-making process about which policies should be implemented and how to increase their effectiveness and sustainability. To fill this gap, we explored public and policymakers' views about factors that influence public acceptability of dietary and active-travel policies and how to increase public acceptability for these policies.

METHODS

We conducted online, semi-structured interviews with 20 members of the public and 20 policymakers in England. A purposive sampling frame was used to recruit members of the public via a recruitment agency, based on age, sex, socioeconomic status and ethnicity. Policymakers were recruited from existing contacts within our research collaborations and via snowball sampling. We explored different dietary and active-travel policies that varied in their scope and focus. Interviews were transcribed verbatim and analysed using thematic reflexive analysis with both inductive and deductive coding.

RESULTS

We identified four themes that informed public acceptability of dietary and active-travel policies: (1) perceived policy effectiveness, i.e., policies that included believable mechanisms of action, addressed valued co-benefits and barriers to engage in the behaviour; (2) perceived policy fairness, i.e., policies that provided everyone with an opportunity to benefit (mentioned only by the public), equally considered the needs of various population subgroups and rewarded 'healthy' behaviours rather than only penalising 'unhealthy' behaviours; (3) communication of policies, i.e., policies that were visible and had consistent and positive messages from the media (mentioned only by policymakers) and (4) how to improve policy support, with the main suggestion being an integrated strategy addressing multiple aspects of these behaviours, inclusive policies that consider everyone's needs and use of appropriate channels and messages in policy communication.

CONCLUSIONS

Our findings highlight that members' of the public and policymakers' support for dietary and active-travel policies can be shaped by the perceived effectiveness, fairness and communication of policies and provide suggestions on how to improve policy support. This information can inform the design of acceptable policies but can also be used to help communicate existing and future policies to maximise their adoption and sustainability.

Impacts of commute mode on body mass index: A longitudinal analysis before and during the COVID-19 pandemic

Introduction

COVID-19 has impacted millions of commuters by decreasing their mobility and transport patterns. While these changes in travel have been studied, less is known about how commute changes may have impacted individuals' body mass index (BMI). The present longitudinal study explores the relationship between commute mode and BMI of employed individuals in Montréal, Canada.

Methods

This study uses panel data drawn from two waves of the Montréal Mobility Survey (MMS) conducted before and during the COVID-19 pandemic (n = 458). BMI was modeled separately for women and men as a function of commuting mode, WalkScore©, sociodemographic, and behavioral covariates using a multilevel regression modeling approach.

Results

For women, BMI significantly increased during the COVID-19 pandemic, but telecommuting frequency, and more specifically telecommuting as a replacement of driving, led to a statistically significant decrease in BMI. For men, higher levels of residential local accessibility decreased BMI, while telecommuting did not have a statistically significant effect on BMI.

Conclusions

This study's findings confirm previously observed gendered differences in the relations between the built environment, transport behaviors, and BMI, while offering new insights regarding the impacts of the changes in commute patterns linked to the COVID-19 pandemic. Since some of the COVID-19 impacts on commute are expected to be lasting, findings from this research can be of use by health and transport practitioners as they work towards generating policies that improve population health.

Prioritising Climate Change Mitigation Behaviours and Exploring Public Health Co-Benefits: A Delphi Study

Climate change requires urgent action; however, it can be challenging to identify individual-level behaviours that should be prioritised for maximum impact. The study aimed to prioritise climate change mitigation behaviours according to their impacts on climate change and public health, and to identify associated barriers and facilitators-exploring the impact of observed behaviour shifts associated with COVID-19 in the UK. A three-round Delphi study and expert workshop were conducted: An expert panel rated mitigation behaviours impacted by COVID-19 in relation to their importance regarding health impacts and climate change mitigation using a five-point Likert scale. Consensus on the importance of target behaviours was determined by interquartile ranges. In total, seven target behaviours were prioritised: installing double/triple glazing; installing cavity wall insulation; installing solid wall insulation; moving away from meat/emission heavy diets; reducing the number of cars per household; walking shorter journeys; and reducing day/weekend leisure car journeys. Barriers related to the costs associated with performing behaviours and a lack of complementary policy-regulated subsidies. The target behaviours are consistent with recommendations from previous research. To ensure public uptake, interventions should address behavioural facilitators and barriers, dovetail climate change mitigation with health co-benefits and account for the long-term impacts of COVID-19 on these behaviours.

The Discriminant Power of Specific Physical Activity and Dietary Behaviors to Distinguish between Lean, Normal and Excessive Fat Groups in Late Adolescents

Physical activity (PA) and dietary behaviors (DBs) are crucial determinants of body mass composition. This work is a continuation of the previous study of PA and DBs patterns in late adolescents. The main aim of this work was to assess the discriminant power of PA and dietary behaviors and to identify the set of variables that discriminated participants with low, normal, and excessive fat the most. The results were also canonical classification functions that can allow the classification of individuals into adequate groups. A total of 107 individuals (48.6% male) participated in examinations, which used the International Physical Activity Questionnaire (IPAQ) and Questionnaire of Eating Behaviors (QEB) to assess PA and DBs. The participants self-reported body height, body weight, and BFP, with the accuracy of the data confirmed and empirically verified. Analyses included the metabolic equivalent task (MET) minutes of PA domains and intensity, and indices of healthy and non-healthy DBs, calculated as a sum of the intake frequency of specific food items. At the beginning, Pearson's r-coefficients and chi-squared tests were calculated to study various relationships between variables, while the main considerations were based on discriminant analyses conducted to determine the set of variables with the most power to distinguish between lean, normal, and excessive body fat groups of participants. Results showed weak relationships between PA domains and strong relationships between PA intensity, sitting time, and DBs. Vigorous and moderate PA intensity related positively to healthy behaviors (r = 0.14, r = 0.27, p < 0.05), while sitting time related negatively to unhealthy DBs (r = -0.16). Sankey diagrams illustrated that lean persons displayed healthy DBs and low sitting time, while those with excessive fat had non-healthy DBs spent more time sitting. The variables that effectively distinguished between the groups include active transport and leisure time domains alongside low-intensity PA, represented by walking intensity and healthy dietary behaviors. The first three variables participated significantly in the optimal discriminant subset (p = 0.002, p = 0.010, p = 0.01, respectively). The discriminant power of the optimal subset (contained four above-mentioned variables) was average (Wilk's Λ = 0.755) and determined that weak relationships between PA domains and DBs resulted from heterogeneous behaviors and mixed patterns of behaviors. Identifying the trajectory of the frequency flow through specific PA and DBs allowed for well-designed tailored intervention programs to improve healthy habits in adolescents. Therefore, identifying the set of variables that discriminate the most between lean, normal, and excessive fat groups is a suitable target for intervention. The practical achievements are canonical classification functions that can be used to classify (predict) participants in groups based on the three the most discriminating PA and DB variables.

Daily Outdoor Cycling by Older Adults Preserves Reactive Balance Behavior: A Case-Control Study

We examined whether older adults who cycle outdoors regularly have better reactive balance control than noncycling older adults. Sixteen cyclist older adults and 24 age-, sex-, and health-matched controls who did not cycle (noncyclists) were exposed to unannounced perturbations of increased magnitudes in standing. We evaluated the strategies and kinematics employed at each perturbation magnitude. We found that cyclists exhibited a significantly higher stepping threshold, lower probability of stepping at each perturbation magnitude, and lower number of trials in which the participant needed to make a step to retain their balance. Cyclists also tended to recover balance using unloaded leg strategies in the first recovery step rather than a loaded leg strategy; they showed faster swing phase duration in the first recovery step, better controlling the displacement of center of mass than noncyclists. Older adults who cycle regularly outdoors preserve their reactive balance functions, which may reduce fall risks.

How the Built Environment Moderates Gender Gap in Active Commuting to Schools

This study investigates the influences of built environmental (BE) factors, network design, and sociodemographic factors on active school travel (AST). Although numerous studies have explored these relationships, this study is trying to assess this issue with a focus on gender differences. Data from a cross-sectional sample of children from first to sixth grades from 16 public primary schools exclusive for girls and boys (N = 1260) in Shiraz collected in November 2019 was used. The analysis of the data revealed that, on average, boys are more willing to walk than girls, but that the boys' tendency to walk is less elastic with respect to distance. Moreover, it is shown that street connectivity for all distance thresholds has a positive relationship with walking level, but the street network choice parameter decreases the chance of walking within an 800 metre threshold. It is demonstrated the need to take gender differences into account in local planning policies to promote AST in a developing country context.

Examining the association between the built environment and active travel using GPS data: A study of a large residential area (Daju) in Shanghai

Automobile dependence and physical inactivity have become common health challenges for residents in large suburban residential areas. Limited literature has examined the associations between the built environment and active travel in such residential areas and the differences in these associations among residents from different neighborhoods. To avoid inaccurate results potentially derived from residence-based measures, we adopt a mobility-based approach for environmental exposure assessment. Using GPS data from 530 trips made by 98 participants in a large residential area in Shanghai, we investigate the relationships between neighborhood types, pollution perceptions, built environment features and active travel. The results indicate that residents in affordable and relocation housing make fewer active trips than those in market-rate housing, while the built environment seems to mitigate this difference. Sports facilities promote active travel while commercial facilities and road intersections discourage it. We identify significant interactions between the percentage of green space and neighborhood type, as well as floor area ratio and air pollution perception. Interventions promoting active travel include active-travel-friendly design for commercial facilities and road intersections, the provision of more sports facilities, a careful increase in floor area ratio, and the provision of more green space that is attractive to residents from different neighborhoods.

School environments and obesity: a systematic review of interventions and policies among school-age students in Latin America and the Caribbean

BACKGROUND

The rapid rise in obesity rates among school children in Latin America and the Caribbean (LAC) could have a direct impact on the region's physical and mental health, disability, and mortality. This review presents the available interventions likely to reduce, mitigate and/or prevent obesity among school children in LAC by modifying the food and built environments within and around schools.

METHODS

Two independent reviewers searched five databases: MEDLINE, Web of Science, Cochrane Library, Scopus and Latin American and Caribbean Health Sciences Literature for peer-reviewed literature published from 1 January 2000 to September 2021; searching and screening prospective studies published in English, Spanish and Portuguese. This was followed by data extraction and quality assessment using the Cochrane risk-of-bias tool (RoB 2) and the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I), adopting also the PRISMA 2020 guidelines. Due to the heterogeneity of the intervention's characteristics and obesity-related measurements across studies, a narrative synthesis was conducted.

RESULTS

A total of 1342 research papers were screened, and 9 studies were included; 4 in Mexico, and 1 each in Argentina, Brazil, Chile, Colombia, and Ecuador. Four studies reported strategies for modifying food provision; four other targeted the built environment, (modifying school premises and providing materials for physical activity); a final study included both food and built environment intervention components. Overall, two studies reported that the intervention was significantly associated with a lower increase over time in BMI/obesity in the intervention against the control group. The remaining studies were non-significant.

CONCLUSIONS

Data suggest that school environmental interventions, complementing nutritional and physical education can contribute to reduce incremental childhood obesity trends. However, evidence of the extent to which food and built environment components factor into obesogenic environments, within and around school grounds is inconclusive. Insufficient data hindered any urban/rural comparisons. Further school environmental intervention studies to inform policies for preventing/reducing childhood obesity in LAC are needed.

Desplazamiento activo en adolescentes: importancia de las barreras percibidas y el acompañamiento

El presente estudio tiene como objetivo conocer el valor predictivo de la edad, el acompañamiento, y las barreras físicas y psicosociales en el desplazamiento activo. Participaron un total de 1325 estudiantes procedentes de centros educativos de Educación Primaria y Educación Secundaria de la Comunidad Autónoma de Extremadura (España), con edades comprendidas entre los 10-17 años (M =12.1; DT= 1.60). Los estudiantes cumplimentaron información sobre el modo, distancia, tiempo y acompañamiento a través del cuestionario PACO, y de las barreras percibidas para el desplazamiento activo mediante la escala BATACE. Los resultados revelaron una importante incidencia del acompañamiento, la distancia y las barreras psicosociales percibidas para la realización de desplazamiento activo hacia el colegio (R2 = .53; p = 0.00). Se concluye en la importancia de la distancia hasta el centro educativo, las barreras psicosociales, y el acompañamiento como elementos más importantes en la realización de desplazamiento activo.

United States' universities are forgetting about equitable bicycle programming on campus

PURPOSE

Regular participation in bicycling offers many health benefits. Universities throughout the U.S. have a large proportion of underrepresented populations among students/employees (e.g., racial/ethnic minorities, LGBTQ+, disabled) who participate in cycling at lower rates. The purpose of this study was to understand the current practices of universities for implementing equitable bicycling programming to their students/faculty/staff.

METHODS

A volunteer sample of U.S. university bicycle representatives (n = 19) were interviewed to analyze current practices, barriers, motivators, and future tools for equitable programming.

RESULTS

Multiple themes emerged from the interview, including barriers to programming such as lack of personnel and finances, as well as motivators such as partnering with off-campus organizations and connecting community/university infrastructures.

CONCLUSIONS

Although various barriers exist for universities which may present decreased equitable programming, university bicycle/alternative transportation departments should consider partnering with on and off-campus organizations rooted into underrepresented populations to better provide equitable programming to these populations.

Patterns of Active Travel and Physical Activity among Adolescents in Israel

Active travel (AT) is a core physical activity (PA) indicator for children and youth; contributing to health and wellbeing, at both the individual and societal levels. This analysis explores patterns of adolescent active school travel (AST) and cycling and associations with different PA measures. Secondary analysis of the cross-sectional 2018-2019 Health Behaviour in School Age Children study in Israel included an extended PA module with walking, cycling and e-cycling modes. The nationally representative sample includes students in grades 6-12 (n = 4407). Analysis of weighted data included descriptive analyses, inferential statistics, and regression analyses. AST was reported by 61.9% of adolescents; 39.3% reported 20 min or more daily AST; 27.1% reported habitual cycling (HC) and 17.4% reported habitual e-cycling (HEC). There are mixed results for socio-economic status and environment. AST and HC were associated with less sedentary hours daily (odds ratio [OR] = 1.190 and 1.397, respectively); HC was associated with positive sports self-rating (OR = 2.394). Stepwise regression analysis found that lower AST duration, time in minutes, was associated with watching television with the family. Promotion of adolescent AT may be associated with increased PA and joint parent-adolescent AT, and was utilized across different socio-demographic groups in Israel.

Inland Waterways and Population Health and Wellbeing: A Cross-Sectional Study of Waterway Users in the UK

Natural environments, such as inland waterways (IWs), have been identified as a potential means to increase physical activity and promote health and wellbeing. However, further information on predictors of IW usage and their relationship with health and wellbeing outcomes is needed. Data were taken from the cross-sectional UK Waterways Engagement Monitor survey of waterway users (n = 21,537) in 2019/2020. Health outcome measures were life satisfaction, physical activity, and mental wellbeing. Visit frequency was an additional outcome measure. Both bivariate and multivariable associations between outcome measures and features of IWs were explored. The travel-cost method was used to estimate users' demand, expressed by travel costs to waterways. Multivariable models showed positive associations of frequent visits and use for recreational/leisure purposes with life satisfaction and physical activity. Rural visits were associated with higher life satisfaction than urban ones. Lower visit satisfaction negatively impacted life satisfaction and mental wellbeing. Visit frequency was influenced by individual characteristics and purpose of visit, including visits for exercise. Waterway visits were inversely associated with travel costs (IRR = 0.99, p-value ≤ 0.001), and there was greater demand elasticity for short distances (≤5 miles). Socioeconomic-related inequalities were present. Future policies could enhance frequent use of waterways and alleviate accessibility-related inequalities to improve population health outcomes.

Associations among Active Commuting to School and Prevalence of Obesity in Adolescents: A Systematic Review

Active commuting to school (ACS) seems to be one of the means to increase physical activity (PA) levels in youth, but it is unclear if ACS reduces the prevalence of obesity, protecting and improving their health. Most of the previous research has been conducted on children or youth (i.e., children with adolescents together), and there is a paucity of research in adolescents only. The purpose of this review was to assess the association between ACS with overweight/obesity parameters in adolescents aged 11 to 19 years. We used PubMed, WOS and SPORTDiscus as electronics databases. All steps of the process followed the recommendations of the PRISMA flow-diagram. Fifteen articles (68.18%) found a consistent association between ACS and body composition and seven studies (31.82%) showed no differences in body composition between active and passive commuters to school. Fourteen studies observed that active commuters to school had a more favorable body composition and one study reported that ACS was associated with unfavourable body composition. ACS could be the steppingstone to improve PA promotion in adolescence but whether ACS is associated with improved body composition and prevention of obesity requires further research.

Correlates and determinants of transport-related physical activity among adults: an interdisciplinary systematic review

INTRODUCTION

Transport-related physical activity (TRPA) has been identified as a way to increase physical activity due to its discretionary and habitual nature. Factors thought to influence TRPA span multiple disciplines and are rarely systematically considered in unison. This systematic review aimed to identify cross-sectional and longitudinal factors associated with adult TRPA across multiple research disciplines.

METHODS

Using four electronic databases, a systematic search of English, peer-reviewed literature from 2010 - 2020 was performed. Studies quantitatively examining factors associated with the outcome of adult TRPA were eligible.

RESULTS

Seventy-three studies (n = 66 cross-sectional; n = 7 longitudinal) were included, cumulatively reporting data from 1,278,632 observations. Thirty-six factors were examined for potential association with TRPA and presented in a social-ecological framework: individual (n = 15), social (n = 3), and environmental (n = 18). Seven factors were found to be consistently associated with higher adult TRPA: lower socio-economic status, higher self-efficacy, higher social normalization, lower distance of travel, higher destination concentration, more streetlighting, and higher public transportation frequency with a greater number of terminals near route start and endpoints.

CONCLUSIONS

This is the first comprehensive compilation of the correlates and determinants of adult TRPA. Seven individual, social, and environmental factors demonstrated consistent associations with TRPA. Models formed using these factors may facilitate more effective promotion of TRPA. There is a lack of longitudinal studies as well as studies assessing cognitive/attitudinal and social factors, highlighting gaps for further research. Those developing policies and strategies targeting TRPA need to consider a range of factors at the individual, social, and environmental level to maximise the likelihood of effectiveness.

Preference for Street Environment Based on Route Choice Behavior While Walking

This study aimed to better understand the relationship between the street environment and walking behavior by deciphering the pedestrians' street environment preference based on their route choice behavior while walking. The route data of 219 residents were collected using an unobtrusive tracking method and subjected to binary logistic regression models to analyze the pedestrian route choice behavior. The results revealed that except for the walking distance, the trip purpose and travel status are the potential factors influencing the route choice of pedestrians. Furthermore, it was revealed that on-street parking, garbage bins, and streetlights could influence the pedestrians to select longer distance routes. In addition, pedestrians were more likely to select the shortest distance route when they were engaged in leisure activities with an accompanist. The findings of this study would offer insights, from different perspectives, into the micro-scale street environment and the walking behavior of pedestrians.

Scenarios of demographic distributional aspects of health co-benefits from decarbonising urban transport

BACKGROUND

There is limited knowledge on the distribution of the health co-benefits of reduced air pollutants and carbon emissions in the transport sector across populations.

METHODS

This Article describes a health impact assessment used to estimate the health co-benefits of alternative land passenger transport scenarios for the city of Beijing, China, testing the effect of five transport-based scenarios from 2020 to 2050 on health outcomes. New potential scenarios range from implementing a green transport infrastructure, to scenarios primarily based on the electrification of vehicle fleets and a deep decarbonisation scenario with near zero carbon emissions by 2050. The health co-benefits are disaggregated by age and sex and estimated in monetary terms.

FINDINGS

The results show that all the alternative mitigation scenarios result in reduced PM_2·5 and CO₂ emissions compared to a business-as-usual scenario during 2020-50. The near zero scenario achieves the largest health co-benefits and economic benefits annually relative to the sole mitigation strategy, preventing 300 (95% CI 229-450) deaths, with health co-benefits and CO₂ cost-saving an equivalent of 0·01% (0·00-0·03%) of Beijing's Gross domestic product in 2015 by 2050. Given Beijing's ageing population and higher mortality rate, individuals aged 50 years and older experience the greatest benefit from the mitigation scenarios. Regarding sex, the greatest health benefits occur in men.

INTERPRETATION

This assessment provides estimates of the demographic distribution of benefits from the effects of combinations of green transport and decarbonising vehicles in transport futures. The results show that there are substantial positive health outcomes from decarbonising transport in Beijing. Policies aimed at encouraging active travel and use of public transport, increasing the safety of active travel, improving public transport infrastructure, and decarbonising vehicles lead to differential benefits. In addition, disaggregation by age and sex shows that the health impacts related to transport pollution disproportionately influence different age cohorts and genders.

FUNDING

National Natural Science Foundation of China and FRIEND Project (through the National Research Foundation of Korea, funded by the Ministry of Science and ICT).

Type and intensity distribution of structured and incidental lifestyle physical activity of students and office workers: a retrospective content analysis

Background

Physical activity (PA) guidelines acknowledge the health benefits of regular moderate-to-vigorous physical activity (MVPA) regardless of bout duration. However, little knowledge exists concerning the type and intensity distribution of structured and incidental lifestyle PA of students and office workers. The present study aimed to i) assess the duration and distribution of intensity of MVPAs during waking hours ≥50% of heart rate reserve (HRR), ii) to identify the type of PA through diary assessment, iii) to assign these activities into structured and lifestyle incidental PA, and iv) to compare this information between students and office workers.

Methods

Twenty-three healthy participants (11 students, 12 office workers) recorded heart rate (HR) with a wrist-worn HR monitor (Polar M600) and filled out a PA diary throughout seven consecutive days (i.e. ≥ 8 waking h/day). Relative HR zones were calculated, and PA diary information was coded using the Compendium of PA. We matched HR data with the reported PA and identified PA bouts during waking time ≥ 50% HRR concerning duration, HRR zone, type of PA, and assigned each activity to incidental and structured PA. Descriptive measures for time spend in different HRR zones and differences between students and office workers were calculated.

Results

In total, we analyzed 276.894 s (76 h 54 min 54 s) of waking time in HRR zones ≥50% and identified 169 different types of PA. The participants spend 31.9 ± 27.1 min/day or 3.9 ± 3.2% of their waking time in zones of ≥50% HRR with no difference between students and office workers (p > 0.01). The proportion of assigned incidental lifestyle PA was 76.9 ± 22.5%.

Conclusions

The present study provides initial insights regarding the type, amount, and distribution of intensity of structured and incidental lifestyle PA ≥ 50% HRR. Findings show a substantial amount of incidental lifestyle PA during waking hours and display the importance of promoting a physically active lifestyle. Future research could employ ambulatory assessments with integrated electronic diaries to detect information on the type and context of MVPA during the day.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12999-z.

Active commuting among workers in the Southern of Brazil: a comparative analysis between 2006 and 2016

This article aims to compare the prevalence of active commuting to work in adults in the Southern region of Brazil between 2006 and 2016 according to sociodemographic and labor characteristics. The data from the Brazilian System for the Surveillance of Risk and Protection Factors for Chronic Diseases - VIGITEL were compared in 2006 and 2016 (≥18 years). Active commuting to work, sex, age group, education and job characteristics were collected by telephone survey and transportation in the cities of Florianópolis, Curitiba and Porto Alegre, using absolute and relative frequencies with their respective 95% confidence intervals. Active commuting increased significantly in 2016 compared to 2006. Florianópolis had the highest prevalence in the two years analyzed. In all capitals, there was a significant increase in the prevalence of the outcome, mainly for women, with secondary education and only in Florianópolis for men, with low schooling. The prevalence has also increased for job characteristics in all capitals. Active commuting to work increased significantly among adults living in southern Brazil, with emphasis on Florianópolis. Expanding interventions in this context is a necessity in Brazil.

Active Commuting and Healthy Behavior among Adolescents in Neighborhoods with Varying Socioeconomic Status: The NESLA Study

(1) Background: The World Health Organization recommends active commuting as a source of physical activity. Active commuting is determined by various factors, including the socioeconomic status (SES) of families and neighborhoods, distance to schools, perceived neighborhood safety, lifestyles and availability of walkways and biking paths. This study aimed to assess factors associated with modes of transportation to and from school among adolescents aged 16–19 living in a middle-sized city in Sweden. (2) Method: Three hundred and fourteen students, of whom 55% were females, from schools in the city of Västerås participated in the study. Printed as well as web-based self-administered questionnaires were used to collect the data. (3) Results: Adolescents living in high SES neighborhoods were 80% more likely to bike or walk to school (OR = 1.80; CI: 1.01, 3.20) than adolescents living in low SES neighborhoods. Furthermore, active commuting was associated with higher consumption of fruits and vegetables (OR = 1.77; CI: 1.05, 2.97) and less consumption of junk foods (OR = 0.43; CI: 0.26, 0.71), as compared to passive commuting. (4) Conclusions: Active commuting is a cost-effective and sustainable source of regular physical activity and should be encouraged at a societal level.

Pedestrian injuries in collisions with pedal cycles in the context of increased active travel: Trends in England, 2005-2015

INTRODUCTION

Increasing levels of active travel in the population brings many public health benefits, but may also change the risks of road injury for different road users. We examined changes in rates of pedestrian injuries resulting from collisions with pedal cycles and motor vehicles in England during 2005-2015, a period of increased cycling activity, and described the gender, age distribution and locations of pedestrians injured in collisions with pedal cycles and motor vehicles.

METHODS

Collisions data were obtained from police STATS19 datasets. We used two measures of cycle/motor vehicle use; miles per annum, and estimated average travel time, and assessed evidence for trends towards increase over time using Poisson regression analysis.

RESULTS

There were 3414 pedestrians injured in collisions with one or more pedal cycles in England during 2005-2015, 763 of whom were killed or seriously injured (KSI). This accounted for 1.3% of the total pedestrians KSI from all vehicles. Of those KSI in collisions with cycles, 62% were female; 42% over the age of 60; 26% were on the footway or verge and 24% were on a pedestrian crossing. There was a 6% (IRR 1.056; 95% CI 1.032-1.080, p < 0.001) annual increase in the pedestrian KSI rate per billion vehicle miles cycled in England over the time span. This increase was disproportionate to the increase in cycle use measured by vehicle miles or time spent cycling.

CONCLUSIONS

Increases in cycling were associated with disproportionate increases in pedestrian injuries in collisions with pedal cycles in England, although these collisions remain a very small proportion of all road injury. Increased active travel is essential for meeting a range of public health goals, but needs to be planned for with consideration for potential impact on pedestrians, particularly older citizens.

Individual, parental and built environmental features as influencing factors of active travel to school in northeast China: findings from a cross-sectional study

OBJECTIVES

Active travel to school (ATS)-associated factors had been studied in some developed countries but rarely in China. We studied the associated factors of ATS at individual, parental and built environment domains in northeast China.

DESIGN AND PARTICIPANTS

A cross-sectional survey was conducted among 4-6 grade students in 2017. Sociodemographic features and information of parents were collected using questionnaires, and SuperMap (a geographical information system software) was used to catch built environment features. Logistic regression models were used to examine the relationship between multilevel factors and ATS.

RESULTS

Our study sample comprised 3670 primary school students aged from 8 to 15 (boys=51.0%, ATS=48.8%). Perceived to be fat (OR 1.25, 95% CI 1.00 to 1.55, p<0.05), feeling easy to walk for a short distance (OR 1.63, 95% CI 1.21 to 2.20, p<0.05), mother unemployed (OR 1.52, 95% CI 1.13 to 2.06, p<0.05), higher land use mix (OR 1.23, 95% CI 1.11 to 1.37, p<0.001) and higher density of public transport stations (OR 1.22, 95% CI 1.09 to 1.37, p<0.05) were positively associated with increased possibility of ATS, while higher household annual income (OR 0.60, 95% CI 0.44 to 0.83, p<0.05) and possession of private vehicles (OR 0.56, 95% CI 0.45 to 0.69, p<0.001) were negatively associated with possibility of ATS.

CONCLUSIONS

The significant factors associated with ATS were at every examined level, which implies multilevel interventions are needed to encourage ATS. Further interventions could focus on the children's willingness to lead students to opt for healthy behaviours, and children from wealthier families should be encouraged to choose ATS. Also, the government should improve built environment walkability so as to encourage ATS.

Validity of a Global Positioning System-Based Algorithm and Consumer Wearables for Classifying Active Trips in Children and Adults

OBJECTIVE

To investigate the convergent validity of a global positioning system (GPS)-based and two consumer-based measures with trip logs for classifying pedestrian, cycling, and vehicle trips in children and adults.

METHODS

Participants (N = 34) wore a Qstarz GPS tracker, Fitbit Alta, and Garmin vivosmart 3 on multiple days and logged their outdoor pedestrian, cycling, and vehicle trips. Logged trips were compared with device-measured trips using the Personal Activity Location Measurement System (PALMS) GPS-based algorithms, Fitbit's SmartTrack, and Garmin's Move IQ. Trip- and day-level agreement were tested.

RESULTS

The PALMS identified and correctly classified the mode of 75.6%, 94.5%, and 96.9% of pedestrian, cycling, and vehicle trips (84.5% of active trips, F1 = 0.84 and 0.87) as compared with the log. Fitbit and Garmin identified and correctly classified the mode of 26.8% and 17.8% (22.6% of active trips, F1 = 0.40 and 0.30) and 46.3% and 43.8% (45.2% of active trips, F1 = 0.58 and 0.59) of pedestrian and cycling trips. Garmin was more prone to false positives (false trips not logged). Day-level agreement for PALMS and Garmin versus logs was favorable across trip modes, though PALMS performed best. Fitbit significantly underestimated daily cycling. Results were similar but slightly less favorable for children than adults.

CONCLUSIONS

The PALMS showed good convergent validity in children and adults and were about 50% and 27% more accurate than Fitbit and Garmin (based on F1). Empirically-based recommendations for improving PALMS' pedestrian classification are provided. Since the consumer devices capture both indoor and outdoor walking/running and cycling, they are less appropriate for trip-based research.

Association between Active Transportation and Public Transport with an Objectively Measured Meeting of Moderate-to-Vigorous Physical Activity and Daily Steps Guidelines in Adults by Sex from Eight Latin American Countries

This study aimed to examine the associations between active transportation and public transport and the objectively measured meeting of moderate-to-vigorous physical activity (MVPA) and steps per day guidelines in adults by sex from eight Latin American countries. As part of the Latin American Study of Nutrition and Health (ELANS), data were collected from 2524 participants aged 18-65 years. MVPA and steps per day were evaluated using Actigraph GT3X accelerometers. The mode of transportation, its frequency and duration were collected using a self-reported questionnaire. The average time dedicated to active transportation was 12.8 min/day in men (IQR: 2.8-30.0) and 12.9 min/day in women (IQR: 4.3-25.7). A logistic regression analysis was conducted, showing that active transportation (≥10 min) was associated with higher odds of meeting MVPA guidelines (men: OR: 2.01; 95%CI: 1.58-2.54; women: OR: 1.57; 95%CI: 1.25-1.96). These results show a greater association when considering active transportation plus public transport (men: OR: 2.98; 95%CI: 2.31-3.91; women: OR: 1.82; 95%CI: 1.45-2.29). Active transportation plus public transport was positively associated with meeting steps per day guidelines only in men (OR: 1.55; 95%CI: 1.15-2.10). This study supports the suggestion that active transportation plus public transport is significantly associated with meeting the MVPA and daily steps recommendations.

Indicators to Assess Physical Health of Children and Adolescents in Activity Research-A Scoping Review

Sufficient physical activity can help promote and maintain health, while its lack can jeopardize it. Since health and physical activity lay their foundation for later life in childhood and adolescence, it is important to examine this relationship from the beginning. Therefore, this scoping review aims to provide an overview of physical health indicators in children and adolescents in research on the effects of physical activity and sedentary behavior. We identified the indicators used to quantify or assess physical health and summarized the methods used to measure these indicators. We systematically searched Scopus, Pubmed, and Web of Science databases for systematic reviews. The search yielded 4595 records from which 32 records were included in the review. The measurements for physical health reported in the reviews contained measures of body composition, cardiometabolic biomarkers, physical fitness, harm/injury, or bone health. Body composition was the most used indicator to assess and evaluate physical health in children, whereas information on harm and injury was barely available. In future research longitudinal studies are mandatory to focus on the prospective relationships between physical activity or sedentary behavior, and physical health.

Overall health impacts of a potential increase in cycle commuting in Stockholm, Sweden

AIMS

To estimate the overall health impact of transferring commuting trips from car to bicycle.

METHODS

In this study registry information on the location of home and work for residents in Stockholm County was used to obtain the shortest travel route on a network of bicycle paths and roads. Current modes of travel to work were based on travel survey data. The relation between duration of cycling and distance cycled was established as a basis for selecting the number of individuals that normally would drive a car to work, but have a distance to work that they could bicycle within 30 minutes. The change in traffic flows was estimated by a transport model (LuTrans) and effects on road traffic injuries and fatalities were estimated by using national hospital injury data. Effects on air pollution concentrations were modelled using dispersion models.

RESULTS

Within the scenario, 111,000 commuters would shift from car to bicycle. On average the increased physical activity reduced the one-year mortality risk by 12% among the additional bicyclists. Including the number of years lost due to morbidity, the total number of disability adjusted life-years gained was 696. The amount of disability adjusted life-years gained in the general population due to reduced air pollution exposure was 471. The number of disability adjusted life-years lost by traffic injuries was 176. Also including air pollution effects among bicyclists, the net benefit was 939 disability adjusted life-years per year.

CONCLUSIONS

Large health benefits were estimated by transferring commuting by car to bicycle.

Is mode of transport to work associated with mortality in the working-age population? Repeated census-cohort studies in New Zealand, 1996, 2001 and 2006

BACKGROUND

Increasing active transport is proposed as a means to address both health and environmental issues. However, the associations between specific modes, such as cycling, walking and public transport, and health outcomes remain unclear. We examined the association between mode of travel to work and mortality.

METHODS

Cohort studies of the entire New Zealand working population were created using 1996, 2001 and 2006 censuses linked to mortality data. Mode of travel to work was that reported on census day, and causes of death examined were ischaemic heart disease and injury. Main analyses were Poisson regression models adjusted for socio-demographics. Sensitivity analyses included: additional adjustment for smoking in the 1996 and 2006 cohorts, and bias analysis about non-differential misclassification of cycling vs car use.

RESULTS

Walking (5%) and cycling (3%) to work were uncommon. Compared with people reporting using motor vehicles to travel to work, those cycling had a reduced all-cause mortality (ACM) in the socio-demographic adjusted models RR 0.87 (0.77-0.98). Those walking (0.97, 0.90-1.04) and taking public transport (0.96, 0.88-1.05) had no substantive difference in ACM. No mode of transport was associated with detectable statistically significant reductions in cause-specific mortality. Sensitivity analyses found weaker associations when adjusting for smoking and stronger associations correcting for likely non-differential misclassification of cycling.

CONCLUSIONS

This large cohort study supports an association between cycling to work and reduced ACM, but found no association for walking or public-transport use and imprecise cause-specific mortality patterns.

The Carbon Footprint of Marathon Runners: Training and Racing

Marathon running leaves a significant carbon footprint regarding CO2 emissions; for example, 37 percent of New York Marathon participants travel internationally to New York. The aim of this study is to estimate the CO2 footprint of a person training and competing in a marathon; we will also propose methods to minimize the CO2 footprint because of transportation. In addition, we also examine the influence of food practices and hygiene on training and racing a marathon.

METHODS

We estimated the annual carbon footprint of one person taking part in a marathon. We considered all training, racing, and travelling (local and international) for one person (we are going to give him the first name of "Henri"), and then compared his CO2 footprint with his colleagues playing tennis and soccer. The excess CO2 footprint whilst running and for shoes, clothing, books, magazines, insurance, travel, hygiene, laundry, and resources for electronics and additional food consumed were calculated. For competitions, we estimated and compared the CO2 emission from transportation to national vs. international marathon (New York).

RESULTS

We estimated that our runner emitted 4.3 tons of CO2 equivalent (CO2e), including all greenhouse gases. A transatlantic flight to New York corresponded to 3.5 tons CO2, which is 83% of the annual carbon footprint of an average French citizen which is about 11 tons CO2e/year. This leads to a sudden 40% increase in Henri's annual carbon footprint.

CONCLUSIONS

By focusing on the additional carbon footprint from one year of marathon training and racing, and traveling locally versus internationally, this sport still has a potentially significant carbon footprint that runners and race organizers ought to consider. We wanted to answer a growing question of marathon runners who are wondering about the carbon footprint of their sports practice in following with a new environmentalist trend that considers not traveling anymore to participate in marathons and to stay local. However, the representativeness in the selection of calculation objectives is very low. There is no need for statistics since this study is a theoretical simulation of traditional training and competition practices of marathon runners.

Access to public transport and childhood obesity: A systematic review

The lack of access to public transport is generally considered to be a risk factor for childhood obesity by discouraging active transport and thus physical activity. To explore the association between access to public transport and childhood obesity, we have conducted a systematic literature search in the Cochrane Library, PubMed, and Web of Science for studies published before January 1, 2019. A total of 25 cross-sectional and two longitudinal studies conducted in 10 countries were identified. Inconsistent findings were identified arising from a great variety of sample characteristics, definitions of exposure (ie, access to public transport), and outcome variables (eg, obesity), and analysis methods. While over half of the studies showed null associations between access to public transport and childhood obesity, we have observed more positive than negative associations among the rest of the studies. These observations suggest that an increased level of access to public transport may have a health-promoting effect and hence prevent the development of childhood obesity. However, this conclusion needs to be further corroborated in future research on the basis of large-sample health surveys, in situ observations, and comparative analyses among different study areas.

Potential for reduced premature mortality by current and increased bicycle commuting: a health impact assessment using registry data on home and work addresses in Stockholm, Sweden

Objectives

The study aims to make use of individual data to estimate the impact on premature mortality due to both existing commuter bicycling and the potential impact due to increased physical activity through shifting transport mode from car commuting to bicycling.

Methods

Using registry data on home and work addresses for the population of Stockholm County the shortest bicycling route on a network of bicycle paths and roads was retrieved. Travel survey data were used to establish current modes of commuting. The relation between duration of bicycling and distance bicycled within the general population in 2015 was established as a basis for identifying individuals that currently drive a car to work but were estimated to have the physical capacity to bicycle to work within 30 min. Within this mode-shift scenario from car-to-bike the duration of bicycling per week was estimated, both among current and potential bicycle commuters. The health impact assessment (HIA) on mortality due to bicycle commuting physical activity was estimated using the same relative risk as within the WHO Health Economic Assessment Tool.

Results

The current number of bicycle commuters were 53 000, and the scenario estimated an additional 111 000. Their mean bicycle distances were 4.5 and 3.4 km, respectively. On average these respective amounts of physical activity reduced the yearly mortality by 16% and 12%, resulting in 11.3 and 16.2 fewer preterm deaths per year.

Conclusion

The HIA of transferring commuting by car to bicycle estimated large health benefits due to increased physical activity.

Associations of active travel with adiposity among children and socioeconomic differentials: a longitudinal study

OBJECTIVES

Examine longitudinal associations between modes of travel to school and adiposity.

SETTING

The UK.

PARTICIPANTS

8432 children surveyed at ages 7, 11 and 14 years from the UK Millennium Cohort Study.

PRIMARY AND SECONDARY OUTCOMES

Objective percentage body fat and body mass index (BMI). Transport mode was categorised as private motorised transport, public transport and active transport (walking or cycling). Socioeconomic position (SEP) was measured by household income group and occupational social class. We adjusted analyses for changes in the country of UK, frequency of eating breakfast, self-reported growth spurts, hours of screen time and days per week of moderate-to-vigorous physical activity. Longitudinal (panel) regression models adjusting for individual fixed effects examined associations in changes in mode of travel to school and adiposity, controlling for both time-varying and time-invariant potential confounders. Interaction tests and stratified analyses investigated differences by markers of SEP.

RESULTS

At age 14 years, 26.1% of children (2198) reported using private motorised transport, 35.3% (2979) used public transport and 38.6% (3255) used active transport to get to school. 36.6% (3083) of children changed mode two times between the three waves and 50.7% (4279) changed once. Compared with continuing to use private transport, switching to active transport was associated with a lower BMI (-0.21 kg/m², 95% CI -0.31 to -0.10) and body fat (-0.55%, 95% CI -0.80% to -0.31%). Switching to public transport was associated with lower percentage body fat (-0.43%, 95% CI -0.75% to -0.12%), but associations with BMI did not reach statistical significance (-0.13 kg/m², 95% CI -0.26 to 0.01). Interaction tests showed a trend for these effects to be stronger in more deprived groups, but these interactions did not reach statistical significance.

CONCLUSION

This longitudinal study during a key life course period found switching to physically active forms of travel can have beneficial adiposity impacts; these associations may be more apparent for more disadvantaged children. Increasing active travel has potential to ameliorate inequalities.

Active Transport to School May Reduce Psychosomatic Symptoms in School-Aged Children: Data from Nine Countries

It is widely proven that being physically active and avoiding sedentary behaviour help to improve adolescents' well-being and keep them in better health in general. We aimed to investigate the relationship between modes of transport to school and subjective complaints among schoolchildren. Analyses were based on the HBSC (Health Behaviour in School-aged Children) surveys conducted in 2017/18 in nine countries (N = 55,607; mean age 13.43 ± 1.64 yrs.). The main outcome showed that health complaints consisted of somatic and psychological complaints. Transport to school was characterized by mode of getting there (walking, biking, or another passive mode). A total of 46.1% of students walked and 7.3% cycled to school; 46.6% commuted by passive means. Biking to school was more frequent in Denmark (37.9%), Norway (26.5%), and Germany (26.6%). The multivariate generalized linear model adjusted for age, gender, country, and school proximity showed that biking to school is protective against reports of health complaints. The beta parameters were equal to -0.498 (p < 0.001) for the general HBSC-SCL index, -0.208 (p < 0.001) for the somatic complaint index, and -0.285 (p < 0.001) for the psychological complaints index. Young people who actively commute to school are less likely to report health complaints, especially psychological symptoms.

The Profile of Bicycle Users, Their Perceived Difficulty to Cycle, and the Most Frequent Trip Origins and Destinations in Aracaju, Brazil

The objective of this study was to describe the profile of bicycle users, their perceived difficulty to cycle, and the most frequent trip origins and destinations in Aracaju, Northeast Brazil. Our cross-sectional study sampled 1001 participants and we collected information through structured interviews. Aged ≥15 years, participants were residents of all Aracaju’s neighborhoods and used a bicycle for commuting to work or for leisure. We observed that bicycle users in Aracaju are predominantly employed male subjects, aged between 18 and 40 years, and were the heads of their households. Most of the them reported “work” as the main reason for their bicycle trips and, “health” and “practicality” aspects as their main motivations for using bicycles. In general, the neighborhoods in the north and center of the city were identified as the most difficult for cycling, and the easiest trips occurred in places with cycle paths. As a conclusion of this study, we reaffirm the need for intersectoral actions that create favorable environments for active commuting and more sustainable cities.

Education for the Anthropocene: Planetary health, sustainable health care, and the health workforce

Over the past few centuries, human activity has wrought dramatic changes in the natural systems that support human life. Planetary health is a useful concept for health profession education (HPE) teaching and practice because it situates health within a broader understanding of the interdependent socio-ecological drivers of human and planetary health. It facilitates novel ways of protecting both population health and the natural environment on which human health and well-being depends. This paper focuses on the climate crisis as an example of the relationship between environmental change, healthcare, and education. We analyze how HPE can help decarbonize the healthcare sector to address both climate change and inequity in health outcomes. Based on the healthcare practitioner's mandate of beneficence, we propose simple learning objectives to equip HPE graduates with the knowledge, skills, and values to create a sustainable health system, using carbon emission reductions as an example. These learning objectives can be integrated into HPE without adding unduly to the curriculum load.

Socio-demographic, behavioural and health-related characteristics associated with active commuting in a regional Australian state: Evidence from the 2016 Tasmanian Population Health Survey

ISSUE ADDRESSED

Physical activity is lower and rates of preventable common diseases are higher in regional/rural than urban Australia. Active commuting (walking/bicycling to get from one place to another) may benefit health through increased physical activity, but most evidence of its correlates come from urban studies. This study aimed to investigate associations between active commuting, socio-demographic characteristics, behaviours, total physical activity and health in a regional/rural Australian state.

METHODS

This study used data from the 2016 Tasmanian Population Health Survey, a representative cross-sectional self-report survey of 6,300 adults in Tasmania, Australia. Logistic regression modelling investigated associations between socio-demographic, behavioural and health characteristics and past week active commuting frequency.

RESULTS

In multivariable models, being younger, having tertiary qualifications, living in a socio-economically advantaged area, being physically active, having a healthy body mass index and good/excellent self-rated health were associated with engaging in more active commuting. Inner regional dwellers were no more likely than outer regional dwellers to actively commute after covariate adjustment.

CONCLUSION

Strategies to promote active commuting in regional/rural areas might consider targeting older adults, those less educated, those living in socio-economically disadvantaged areas, those less physically active, those with poorer health and those with higher body mass index. Research could further investigate why these groups appear to be less active for commuting purposes. SO WHAT?: Increasing physical activity and active commuting may help to reduce rates of preventable common diseases in regional/remote areas.

A Review of Advancement on Influencing Factors of Acne: An Emphasis on Environment Characteristics

Background: Acne vulgaris is known as a commonly-seen skin disease with a considerable impact on the quality of life. At present, there have been a growing number of epidemiological, medical, demographic and sociological researches focusing on various influencing factors in the occurrence of acne. Nevertheless, the correlation between environmental factors and acne has yet to be fully investigated. Objective: To assess the impacts of individual, natural and social environmental factors on acne and to construct a framework for the potential impact of built environment on acne. Methods: A thorough review was conducted into the published social demographical, epidemiological, and environmental studies on acne through PubMed, Google Scholar and Web of Science, with reference made to the relevant literature. Results: The influencing factors in acne are classed into four major categories. The first one includes individual socio-economic and biological factors, for example, gender, age, economic level, heredity, obesity, skin type, menstrual cycle (for females), diet, smoking, cosmetics products, electronic products, sleep quality and psychological factors. The second one includes such natural environmental factors as temperature, humidity, sun exposure, air pollution and chloracne. The third one relates to social environment, including social network and social media. The last one includes built environmental factors, for example, population density, food stores, green spaces, as well as other built environment characteristics for transport. Acne can be affected negatively by family history, overweight, obesity, oily or mixed skin, irregular menstrual cycles, sugary food, greasy food, dairy products, smoking, the improper use of cosmetics, the long-term use of electronics, the poor quality of sleep, stress, high temperature, sun exposure, air pollution, mineral oils and halogenated hydrocarbons. Apart from that, there are also potential links between built environment and acne. Conclusions: It is necessary to determine the correlation between the built environment and acne based on the understanding of the impact of traditional factors (sociology of population and environment) on acne gained by multidisciplinary research teams. Moreover, more empirical studies are required to reveal the specific relationship between built environment and acne.

Autonomous vehicles and cycling: Policy implications and management issues

Cycling as a form of active transport has great benefits for individuals and society, yet prevalence rates in many countries are low. The advent of autonomous vehicles (AVs) is likely to have substantial implications for cyclists, however little is known about the nature and magnitude of the likely impacts and the resulting implications for government planning and policy. The aim of this exploratory study was to consult with a range of stakeholder groups to identify relevant issues and stimulate debate about future efforts to maximize the benefits of vehicle autonomy for cycling outcomes. Interviews were conducted with key stakeholders representing government (local, state, and federal departments responsible for transport, health, and/or infrastructure), cycling organizations, technology firms, AV manufacturing/servicing companies, trade unions, the law, insurers (public and private), transport policy consortia, and academia. The results suggest that AVs have the potential to increase cycling prevalence while reducing cycling accidents, but that a range of issues will need to be addressed to optimize these outcomes. In particular, informed decisions need to be made about the infrastructure and equipment investments that could encourage larger numbers of commuters to select cycling as their primary form of transport.

Active design of built environments for increasing levels of physical activity in adults: the ENABLE London natural experiment study

Background

Low physical activity is widespread and poses a serious public health challenge both globally and in the UK. The need to increase population levels of physical activity is recognised in current health policy recommendations. There is considerable interest in whether or not the built environment influences health behaviours, particularly physical activity levels, but longitudinal evidence is limited.

Objectives

The effect of moving into East Village (the former London 2012 Olympic and Paralympic Games Athletes’ Village, repurposed on active design principles) on the levels of physical activity and adiposity, as well as other health-related and well-being outcomes among adults, was examined.

Design

The Examining Neighbourhood Activities in Built Environments in London (ENABLE London) study was a longitudinal cohort study based on a natural experiment.

Setting

East Village, London, UK.

Participants

A cohort of 1278 adults (aged ≥ 16 years) and 219 children seeking to move into social, intermediate and market-rent East Village accommodation were recruited in 2013–15 and followed up after 2 years.

Intervention

The East Village neighbourhood, the former London 2012 Olympic and Paralympic Games Athletes’ Village, is a purpose-built, mixed-use residential development specifically designed to encourage healthy active living by improving walkability and access to public transport.

Main outcome measure

Change in objectively measured daily steps from baseline to follow-up.

Methods

Change in environmental exposures associated with physical activity was assessed using Geographic Information System-derived measures. Individual objective measures of physical activity using accelerometry, body mass index and bioelectrical impedance (per cent of fat mass) were obtained, as were perceptions of change in crime and quality of the built environment. We examined changes in levels of physical activity and adiposity using multilevel models adjusting for sex, age group, ethnic group, housing sector (fixed effects) and baseline household (random effect), comparing the change in those who moved to East Village (intervention group) with the change in those who did not move to East Village (control group). Effects of housing sector (i.e. social, intermediate/affordable, market-rent) as an effect modifier were also examined. Qualitative work was carried out to provide contextual information about the perceived effects of moving to East Village.

Results

A total of 877 adults (69%) were followed up after 2 years (mean 24 months, range 19–34 months, postponed from 1 year owing to the delayed opening of East Village), of whom 50% had moved to East Village; insufficient numbers of children moved to East Village to be considered further. In adults, moving to East Village was associated with only a small, non-significant, increase in mean daily steps (154 steps, 95% confidence interval –231 to 539 steps), more so in the intermediate sector (433 steps, 95% confidence interval –175 to 1042 steps) than in the social and market-rent sectors (although differences between housing sectors were not statistically significant), despite sizeable improvements in walkability, access to public transport and neighbourhood perceptions of crime and quality of the built environment. There were no appreciable effects on time spent in moderate to vigorous physical activity or sedentary time, body mass index or percentage fat mass, either overall or by housing sector. Qualitative findings indicated that, although participants enjoyed their new homes, certain design features might actually serve to reduce levels of activity.

Conclusions

Despite strong evidence of large positive changes in neighbourhood perceptions and walkability, there was only weak evidence that moving to East Village was associated with increased physical activity. There was no evidence of an effect on markers of adiposity. Hence, improving the physical activity environment on its own may not be sufficient to increase population physical activity or other health behaviours.

Funding

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 12. See the NIHR Journals Library website for further project information. This research was also supported by project grants from the Medical Research Council National Prevention Research Initiative (MR/J000345/1).

Fuelling walking and cycling: human powered locomotion is associated with non-negligible greenhouse gas emissions

Reducing motorized transport and increasing active transport (i.e. transport by walking, cycling and other active modes) may reduce greenhouse gas (GHG) emissions and improve health. But, active modes of transport are not zero emitters. We aimed to quantify GHG emissions from food production required to fuel extra physical activity for walking and cycling. We estimate the emissions (in kgCO₂e) per kilometre travelled for walking and cycling from energy intake required to compensate for increased energy expenditure, and data on food-related GHG emissions. We assume that persons who shift from passive modes of transport (e.g. driving) have increased energy expenditure that may be compensated with increased food consumption. The GHG emissions associated with food intake required to fuel a kilometre of walking range between 0.05 kgCO₂e/km in the least economically developed countries to 0.26 kgCO₂e/km in the most economically developed countries. Emissions for cycling are approximately half those of walking. Emissions from food required for walking and cycling are not negligible in economically developed countries which have high dietary-related emissions. There is high uncertainty about the actual emissions associated with walking and cycling, and high variability based on country economic development. Our study highlights the need to consider emissions from other sectors when estimating net-emissions impacts from transport interventions.

A Scoping Review of Children and Adolescents' Active Travel in Ireland

There appears to be a lack of existing data that comprehensively summarizes the evidence of children and adolescents’ active travel in the Republic of Ireland. In lieu of this, a scoping review was conducted to map the existing literature (2000–2020) on children and adolescents’ active travel in the Republic of Ireland. A scoping review design extracted a total of 19 publications, which show a consistent focus on the identified population’s active travel patterns, mainly to and from school, mostly self-report and cross-sectional research study designs; however, there are few longitudinal data, intervention and participatory studies. Key issues from these identified scoping review studies are discussed with the potential to better inform policy makers, practitioners and researchers to delineate programmes and strategies for promoting active travel among children and adolescents in the Republic of Ireland.