Active travel

Moderate positive impact based on uncertain evidence with low resource implications

Description

Description

Active travel, also described as active transport or transportation, is defined as making journeys that involve a level of physical exercise (UK Department 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, and accelerometry or digital tracking device/GPS.

Findings

Findings

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.

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:

  1. 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)
  2. smaller and calmer car traffic, offering greater safety for cyclists and pedestrians (de Carvalho 2012; Gomez 2015)
  3. short distances of trips (de Carvalho 2012; Gomez 2015; Sallis 2015; Stankov 2020)
  4. aesthetics of the streets and facilities (cleanliness, low noise, presence of trees/greenery) (de Carvalho 2012; Rachele 2019; Sallis 2015)
  5. mixed land use, combining residential, commercial, and leisure spaces and facilities within a concentrated area (Gomez 2015; Kim 2019; Rachele 2019; Sallis 2015)
  6. the financial cost and economic benefits (de Carvalho 2012; Sallis 2015)
  7. 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, multicomponent 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).

Impact

Impact

All included reviews found that active travel had a positive impact on health and wellbeing, however, statistical conclusions could not be assigned due to the quality and heterogeneity of the evidence. In particular, designing community environments that make active travel convenient, safe, attractive, cost-effective, and environmentally beneficial is likely to produce the greatest impact.

Evidence illustrated that levels of residential density can impede or promote uptake of active travel (Barnett 2017; Graham 2020; Rachele 2019). However, future research is needed to identify the optimal threshold of density for supporting active travel, which will be important for informing planning policy and practice. Other recommendations included: 

  1. policies to increase investment in infrastructure for pedestrians and cyclists, which are critical in promoting active travel
  2. inter-disciplinary teams involving those from the transport, planning, public health, and policy sectors should embrace opportunities to work collaboratively to implement and evaluate active transport interventions. This collaborative approach will also help address some of the methodological weaknesses identified in the reviews. 
  3. invest in high-quality research, including longitudinal research designs, adjusting for residential self-selection, conceptually-driven choosing of built environmental attributes, pooling data from different countries based on valid standardized measures, and adjusting for key socio-demographic covariates. In studies where physical activity is an outcome, using validated physical activity measures (including, where necessary, appropriate accelerometer cut-points) is also recommended.

Resources

Resources 

Resource implications were graded low because of the extent of co-benefits of 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 United States to exceed $8 billion/year (Xia 2013).

Micro-level interventions that increase attractiveness and convenience for active travel are low-cost and more easily implemented 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). Implementation of economic incentives, such as congestion and parking fees, were found to promote active travel and significantly improve health (Stankov 2020).

Overall, investment in infrastructure for pedestrians and cyclists is critical to ensure safety and promote the use of active travel.

Quality

Quality 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. 

Links

External links to related sources 
New London Architecture: Active Travel Summer 2021

References


References of included reviews

Audrey S and Batista-Ferrer H (2015) Healthy urban environments for children and young people: A systematic review of intervention studies. Health & place 36: 97–117.

Barnett DW, Barnett A, Nathan A, et al. (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 ML and de Freitas CM (2012) Cycling to achieve healthy and sustainable alternatives. Ciencia & saude coletiva 17(6): 1617–1628.

Gomez LF, Sarmiento R, Ordoñez MF, et al. (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 H, de Bell S, Flemming K, et al. (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 DH and Yoo S (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 FJM, Panter J, Burdorf A, et al. (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 THM, Kesten JM, López-López JA, et al. (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 JN, Sugiyama T, Davies S, et al. (2019) Neighbourhood built environment and physical function among mid-to-older aged adults: A systematic review. Health & place 58: 102137.

Sallis JF, Spoon C, Cavill N, et al. (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 M, Hosking J, Woodward A, et al. (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 I, Garcia LMT, Mascolli MA, et al. (2020) A systematic review of empirical and simulation studies evaluating the health impact of transportation interventions. Environmental research 186: 109519.

Winters M, Buehler R and Götschi T (2017) Policies to Promote Active Travel: Evidence from Reviews of the Literature. Current environmental health reports 4(3): 278–285.

Xia T, Zhang Y, Crabb S, et al. (2013) Cobenefits of replacing car trips with alternative transportation: a review of evidence and methodological issues. Journal of environmental and public health 2013: 797312.