Public Transport – Healthy Cities Toolkit

Description

Public transport, or mass transit, is the movement of people within urban areas using group travel technologies, e.g., buses and trains [Britannica].

Public transport has been described as “The most efficient and equitable solution for urban mobility and climate change” [Institute for Transportation and Development Policy]. Interventions aimed at reducing car use and promoting cycling, and the use of public transport have been reported to decrease greenhouse gas emissions and improve health outcomes of travellers and the general population [Rojas-Rueda 2012].

Impact

Public transport interventions have a moderate positive impact on health outcomes.

Results

Two reviews comprising a total of 48 primary studies were identified. One systematic review (n=9 articles) assessed the benefits of mass public transportation on climate change mitigation [Kwan 2016].

The second systematic review (n=39 studies) assessed the impact of transportation interventions on health outcomes [Stankov 2020]. Twenty-nine included studies were longitudinal evaluations, while 10 were simulation studies. Five studies were focused on low- and middle-income countries’ (LMICs) contexts.

Effect of Public Transportation on Health and other outcomes

Multi-component interventions may be more effective than single-component interventions in increasing physical activity [Kwan 2016; Stankov 2020]
Public transport scenarios were most effective at preventing traffic injuries [Kwan 2016]
Aerial tram installation resulted in a significant decrease in homicide rates (1 study) [Stankov 2020]
Bicycle lane interventions were associated with increases in physical activity and active transport [Kwan 2016; Stankov 2020]
BRT systems with an adjacent bicycle lane promoted active travel and walking for transport and recreation [Stankov 2020]
Financial incentives designed to discourage car use, and policies designed to improve the public transportation system, had positive impacts on active travel time and bus share [Stankov 2020]

Strength of the Evidence

In Stankov 2020, the reporting quality of included studies was mixed. Kwan 2016 did not report the quality of the included studies.

Recommendations

Further evaluation and system-based simulation studies are needed to assess the effect of bicycle lanes, BRT systems, aerial trams and Open Streets programs on health outcomes, especially in LMICs.
Future studies should have rigorous designs, be representative of the population samples, have valid comparison groups, and incorporate before and after assessments.
The utilisation of street imagery (e.g., Google Street View) can help capture more detailed data about the physical environment and behaviour of travellers.
Use of a citizen science approach that empowers local residents to collect relevant data about their community, prioritise areas of concern, and engage in multi-disciplinary collaboration.
Local sources of exposure data should be incorporated into future study designs to allow for an accurate assessment of travellers’ exposure to air pollution.

Resource implications

None of the included reviews provided information regarding resource implications. However, their implementation requires sustained resources over the medium to long term.

Related Resources

Institute for Transportation and Development Policy. “Public Transport.” Available at: https://www.itdp.org/our-work/public-transport/

Rojas-Rueda 2012. “Replacing car trips by increasing bike and public transport in the greater Barcelona metropolitan area: a health impact assessment study.” Environment international vol. 49 (2012): 100-9.

Reference to Reviews

Kwan 2016. “A review on co-benefits of mass public transportation in climate change mitigation.” Sustainable Cities and Society Volume 22, April 2016, Pages 11-18

Stankov 2020. “A systematic review of empirical and simulation studies evaluating the health impact of transportation interventions.” Environmental research vol. 186 (2020): 109519. doi:10.1016/j.envres.2020.109519