Active travel, also described as active transport or transportation, is defined as making journeys that involve a level of physical exercise. (UK Dept for Transport, 2022).
It can include walking, cycling, skating or skateboarding (to name a few) and is highly favourable when commuting to work or school. In the literature, active travel was measured using self-reported instruments, surveys or questionnaires, interviews or focus groups, accelerometry, digital tracking devices or GPS.
Fourteen reviews considered the health impacts of active transport involving nearly 500 primary studies. Overall, active travel had a positive effect on increasing rates of physical activity, reducing non-communicable diseases, and improving mental health.
Designing community environments that make active travel convenient, safe, attractive, cost-effective, and environmentally beneficial is likely to produce the greatest impact.
The included reviews represented the ages of the general population, with one review focusing on children and young people (Audrey 2015) and two reviews on older people (Barnett 2017; Graham 2020). Three reviews restricted their geographical scope, with one review from the UK, (Graham 2020) Korea, (Kim 2019) and Latin America. (Gomez 2015) The remaining reviews did not restrict the geographical scope and found that most primary studies were conducted in North America, Europe, and Oceania.
Most (85%) reviews assessed rates of physical activity and examined the relationship of the urban environment in promoting active transport, which found that active travel increased exercise. The reviews identified various factors that supported active travel, including:
- Adequate infrastructure (e.g. cycle lanes) and connection/continuity of cyclable and walkable surfaces (de Carvalho 2012; Gomez 2015; Mölenberg 2019; Rachele 2019; Sallis 2015; Smith 2017; Stankov 2020)
- Smaller and calmer car traffic, offering greater safety for cyclists and pedestrians (de Carvalho 2012; Gomez 2015)
- Short distances of trips (de Carvalho 2012; Gomez 2015; Sallis 2015; Stankov 2020)
- Aesthetics of the streets and facilities (cleanliness, low noise, presence of trees/greenery) (de Carvalho 2012; Rachele 2019; Sallis 2015)
- Mixed land use, combining residential, commercial, and leisure spaces and facilities within a concentrated area (Gomez 2015; Kim 2019; Rachele 2019; Sallis 2015)
- The financial cost and economic benefits (de Carvalho 2012; Sallis 2015)
- The environment and sustainable mobility (de Carvalho 2012; Gomez 2015; Sallis 2015)
Factors that discouraged cycling were related to geography (e.g. weather or terrain) and individual factors (e.g. age, sex, education levels). The lack of connectivity of cycling routes, zoning and land use distribution, and low petrol prices encouraged individuals to use cars. (de Carvalho 2012)
Factors that both encouraged and discouraged active travel were dependent on the socio-economic conditions of populations and the economic development of countries, which drove the adoption of public policies. (de Carvalho 2012). For example, in Australia, lower economic status was a factor that reduced the use of bicycles by children attending schools, whereas, in Brazil, lower socio-economic profiles were linked to higher rates of active travel when commuting to schools.
For children and young people, multi-component and single-component interventions deployed at schools increased students’ activity levels and reduced parental driving. (Audrey 2015)Factors such as distance from home to school, infrastructure improvements (e.g. cycle lanes, calming traffic schemes), education, and non-car use at baseline influenced active travel over time.
For older adults, neighbourhood walkability, access to destinations and services and recreational facilities, crime/personal safety, residential density, walk-friendly infrastructure, street lighting, the presence of greenery and aesthetically pleasing scenery were positively associated with physical activity and walking. (Barnett 2017; Rachele 2019) In the UK, cost, availability, connectivity and infrastructure, such as benches and bus shelters, were crucial in enabling active travel amongst elderly individuals. (Graham 2020)
One review considered non-communicable diseases, identifying positive effects for people with diabetes, cardiovascular disease, breast and colon cancer, and dementia, as well as all-cause mortality and the incidence of overweight and obesity. (Xia 2013).
One review focused on mental health and found that people who actively commuted to work (cycling/walking) reported improved mental health outcomes, but this effect was reduced after baseline mental health was accounted for. (Moore 2018)
One review examined policies to promote active travel, which found that infrastructure is at the core of promoting active travel, but policies may work best when implemented in comprehensive packages (Winters 2017).
Strength of the evidence
Strength of the evidence
Three reviews (21%) used a tool to assess the risk of bias or quality, which had moderate, (Barnett 2017) low, (Moore 2018) and very low-quality evidence. (Audrey 2015) The remaining 11 reviews were therefore ranked uncertain, giving the overall score of uncertain evidence. Despite the uncertainty in the quality of the evidence, action should not be postponed until stronger evidence is developed, as the health, environmental, and economic benefits of active travel are clear.
Searches for evidence were conducted between 2010 and 2019 in a median of six databases. Ten of the included studies were formal systematic reviews (two with meta-analyses, one using mixed methods, and one with qualitative studies), three were literature reviews, and one was an overview of systematic reviews.
Resource implications were graded low because of the extent of the co-benefits afforded by active travel. In addition to positive health outcomes, reviews reported the economic and environmental benefits, including reducing traffic congestion, accidents, and air and noise pollution (Graham 2020; Sallis 2015; Smith 2017; Winters 2017; Xia 2013).
One review estimated the combined economic benefit of eliminating short motor vehicle trips in 11 metropolitan areas in the upper mid-western USS to exceed $8 billion/year. (Xia 2013)
Micro-level interventions that increase attractiveness and convenience for active travel are low-cost and easier to implement than macro-level interventions for street design and layout. (Barnett 2017; Winters 2017) These can include planting trees and flora, limiting car parking, introducing lower speeds, and making areas pedestrian-friendly.
The rising costs of car transport and petrol prices have reportedly increased the uptake of active travel. (de Carvalho 2012; Mölenberg 2019)The implementation of economic incentives, such as congestion and parking fees, was found to promote active travel and significantly improve health. (Stankov 2020)
- Increase investment in infrastructure for pedestrians and cyclists to promote active travel.
- Use interdisciplinary teams involving those from the transport, planning, public health, and policy sectors should embrace opportunities to implement and evaluate active transport interventions.
- Invest in high-quality research, adjusting for residential self-selection, conceptually-driven choosing of built environmental attributes, and adjusting for key socio-demographic covariates.
- Research is needed to identify the optimal density threshold that supports active travel, which is important for informing planning policy and practice.
- WHO (2018): Global Action Plan on Physical Activity 2018-2030 – More Active People for a Healthier World
- WHO (2020): Physical activity
- UK Department for Transport (2022): Active Travel – Local authority toolkit (guidance)
- UK Department for Transport (2020): Cycling and walking plan for England (policy paper)
- UK Department for Transports (2019): Future of mobility – urban strategy (policy paper)
- Public Health England (2016): Active travel – a briefing for local authorities
- Healthy Places by Design (2001-2008): Active Living by Design
- Sustrans (2017): Active Travel Toolbox
- Open Streets Project
- Active Living Research: Tools and Resources
- Living Streets: UK Charity for Everyday Walking
- Choose how you move: A smarter way to travel in Leicester and Leicestershire
- Transport Scotland: Walking and cycling
- Imperial College London: Active travel
- National Walk to Work Day: UK Public Health Network
References to Reviews
References of Reviews
Audrey 2015. Healthy urban environments for children and young people: A systematic review of intervention studies. Health & place 36: 97–117.
Barnett 2017. Built environmental correlates of older adults’ total physical activity and walking: a systematic review and meta-analysis. The international journal of behavioral nutrition and physical activity 14(1): 103.
de Carvalho 2012. Cycling to achieve healthy and sustainable alternatives. Ciencia & saude coletiva 17(6): 1617–1628.
Gomez 2015. Urban environment interventions linked to the promotion of physical activity: a mixed methods study applied to the urban context of Latin America. Social science & medicine 131: 18–30.
Graham 2020. Older people’s experiences of everyday travel in the urban environment: a thematic synthesis of qualitative studies in the United Kingdom. Ageing & Society 40(4). Cambridge University Press: 842–868.
Kim 2019. How Does the Built Environment in Compact Metropolitan Cities Affect Health? A Systematic Review of Korean Studies. International journal of environmental research and public health 16(16). DOI: 10.3390/ijerph16162921.
Mölenberg 2019. A systematic review of the effect of infrastructural interventions to promote cycling: strengthening causal inference from observational data. The international journal of behavioral nutrition and physical activity 16(1): 93.
Moore 2018. The effects of changes to the built environment on the mental health and well-being of adults: Systematic review. Health & place 53: 237–257.
Rachele 2019. Neighbourhood built environment and physical function among mid-to-older aged adults: A systematic review. Health & place 58: 102137.
Sallis 2015. Co-benefits of designing communities for active living: an exploration of literature. The international journal of behavioral nutrition and physical activity 12: 30.
Smith 2017. Systematic literature review of built environment effects on physical activity and active transport – an update and new findings on health equity. The international journal of behavioral nutrition and physical activity 14(1): 158.
Stankov 2020. A systematic review of empirical and simulation studies evaluating the health impact of transportation interventions. Environmental research 186: 109519.
Winters 2017. Policies to Promote Active Travel: Evidence from Reviews of the Literature. Current environmental health reports 4(3): 278–285.
Xia 2013. Co-benefits of replacing car trips with alternative transportation: a review of evidence and methodological issues. Journal of environmental and public health 2013: 797312.