Transit and Health: Mode of Transport, Employer-Sponsored Public Transit Pass Programs, and Physical Activity

School of Community & Regional Planning, University of British Columbia, Vancouver, BC, Canada.
Journal of Public Health Policy (Impact Factor: 1.78). 01/2009; 30 Suppl 1:S73-94. DOI: 10.1057/jphp.2008.52
Source: PubMed


Increased provision of transit service and policy incentives that favor transit use can support a physically active lifestyle. We used the smartraq travel survey in metropolitan Atlanta, Georgia (in 2001-2002) to assess whether transit and car trips were associated with meeting the recommended levels of physical activity by using walking as a means of transportation. Additionally, we assessed associations between walking and using an employer-sponsored public transit pass. We controlled for demographics, neighborhood density, presence of services near workplaces, distance from home to transit, and car availability in our sample of 4,156 completed surveys. Walking distances from origin to destination were derived by a geographical information system and categorized as: no walking, moderate walking, or meeting recommendation (walking>or=2.4 km (1.5 miles) a day, approximately>or=30 min). In a multinomial logistic regression controlling for other covariates, transit trips were associated with an odds ratio (OR) of 3.87 (confidence interval (CI) 95%, 2.93-5.11) of meeting recommendation. In a multinominal logistical regression controlling for other covariates, transit users were associated with meeting recommendation, OR 2.23 (CI 95%, 1.27-3.90).

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Available from: Lawrence D Frank, Aug 20, 2014
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    • "Moreover, there is a general lack of evidence to inform the case for or against the use of economic instruments to promote physical activity (see Tables 1, 2, S2 and S3). Overall, we identified two primary studies that assessed congestion charges (taxes) [45,46]; two that assessed employer-sponsored benefit schemes (transfer payments) to promote employees’ use of, respectively, health clubs and public transport [47,48]; and one that evaluated tax credits (transfer payments) provided to parents who had enrolled their children in organised physical activity programmes [49]. This finding is consistent with, and adds little to, those of the six published reviews we identified that included coverage of the use of economic instruments to promote physical activity [50-55]. "
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    ABSTRACT: Unhealthy diet and low levels of physical activity are common behavioural factors in the aetiology of many non-communicable diseases. Recent years have witnessed an upsurge of policy and research interest in the use of taxes and other economic instruments to improve population health. To assemble, configure and analyse empirical research studies available to inform the public health case for using economic instruments to promote dietary and physical activity behaviour change. We conducted a systematic scoping review of evidence for the effects of specific interventions to change, or general exposure to variations in, prices or income on dietary and physical activity behaviours and corollary outcomes. Systematic electronic searches and parallel snowball searches retrieved >1 million study records. Text mining technologies were used to prioritise title-abstract records for screening. Eligible studies were selected, classified and analysed in terms of key characteristics and principal findings, using a narrative, configuring synthesis focused on implications for policy and further research. We identified 880 eligible studies, including 192 intervention studies and 768 studies that incorporated evidence for prices or income as correlates or determinants of target outcomes. Current evidence for the effects of economic instruments and exposures on diet and physical activity is limited in quality and equivocal in terms of its policy implications. Direct evidence for the effects of economic instruments is heavily skewed towards impacts on diet, with a relative lack of evidence for impacts on physical activity. The evidence-based case for using economic instruments to promote dietary and physical activity behaviour change may be less compelling than some proponents have claimed. Future research should include measurement of people's actual behavioural responses using study designs capable of generating reliable causal inferences regarding intervention effects. Policy implementation needs to be carefully aligned with evaluation planning and design.
    PLoS ONE 09/2013; 8(9):e75070. DOI:10.1371/journal.pone.0075070 · 3.23 Impact Factor
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    • "Other studies by Yang et al. [42] and Sahlqvist et al. [44] found a positive relationship between AC and daily physical activity participation and other studies have confirmed that more time spent in cars is associated with less time for physical activity participation [58]. Using public transportation can often serve as a catalyst for encouraging physical activity; for example, studies have shown that using public transportation is associated with significant walking to and from transit [43, 59], and many individuals meet current physical activity recommendations through active transport to and from transit locations [43, 60]. Therefore, where feasible, public health campaigns may wish to encourage transit use over vehicular commuting, and this strategy and behavior may be more palatable to a large segment of the population who eschew the idea of biking and walking to work. "
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    ABSTRACT: Active commuting (AC) to the workplace is a potential strategy for incorporating physical activity into daily life and is associated with health benefits. This study examined the association between health-related factors and mode of travel to the workplace. Methods. A volunteer convenience sample of employed adults completed an online survey regarding demographics, health-related factors, and the number of times/week walking, biking, driving, and using public transit to work (dichotomized as no walk/bike/drive/PT and walk/bike/drive/PT 1 + x/week). Logistic regression was used to predict the likelihood of each mode of transport and meeting PA recommendations from AC according to demographics and health-related factors. Results. The sample (n = 1175) was aged 43.5 ± 11.4 years and was primarily White (92.7%) and female (67.9%). Respondents reported walking (7.3%), biking (14.4%), taking public transit (20.3%), and driving (78.3%) to work at least one time/week. Among those reporting AC, 9.6% met PA recommendations from AC alone. Mode of travel to work was associated with several demographic and health-related factors, including age, number of chronic diseases, weight status, and AC beliefs. Discussion. Mode of transportation to the workplace and health-related factors such as disease or weight status should be considered in future interventions targeting AC.
    Journal of Environmental and Public Health 02/2013; 2013(7):242383. DOI:10.1155/2013/242383
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    • "Even though biking and walking to work and school would be most effective, for most Americans the choice, if any, is between car and public transportation (PT). PT users walk and climb stairs more than car commuters do, as a result of moving to, from, and within stations (Besser and Dannenberg, 2005; Edwards, 2008; Lachapelle and Frank, 2009; Ogilvie et al., 2004). We have documented the higher physical energy expenditure of PT users during their work commute compared to car drivers (Morabia et al., 2009, 2010). "
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    ABSTRACT: Commuting by public transportation (PT) entails more physical activity and energy expenditure than by cars, but its biologic consequences are unknown. In 2009-2010, we randomly sampled New York adults, usually commuting either by car (n=79) or PT (n=101). Measures comprised diet and physical activity questionnaires, weight and height, white blood cell (WBC) count, C reactive protein, (CRP) gene-specific methylation (IL-6), and global genomic DNA methylation (LINE-1 methylation). Compared to the 101 PT commuters, the 79 car drivers were about 9 years older, 2 kg/m(2) heavier, more often non-Hispanic whites, and ate more fruits and more meats. The 2005 guidelines for physical activity were met by more car drivers than PT users (78.5% vs. 65.0%). There were no differences in median levels of CRP (car vs. PT: 0.6 vs. 0.5mg/dl), mean levels of WBC (car vs. PT: 6.7 vs. 6.5 cells/mm(3)), LINE-1 methylation (car vs. PT: 78.0% vs. 78.3%), and promoter methylation of IL-6 (car vs. PT: 56.1% vs. 58.0%). PT users were younger and lighter than car drivers, but their commute mode did not translate into a lower inflammatory response or a higher DNA methylation, maybe because, overall, car drivers were more physically active.
    Preventive Medicine 01/2012; 54(3-4):229-33. DOI:10.1016/j.ypmed.2012.01.019 · 3.09 Impact Factor
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