Alistair Woodward

University of Auckland, Окленд, Auckland, New Zealand

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Publications (130)728.9 Total impact

  • Alistair Woodward ·

    Addiction 09/2015; 110(9):1493-4. DOI:10.1111/add.13024 · 4.74 Impact Factor
  • Sandar Tin Tin · Alistair Woodward · Shanthi Ameratunga ·

  • Alistair Woodward ·

    The Lancet 07/2015; DOI:10.1016/S0140-6736(15)61216-8 · 45.22 Impact Factor
  • Hayley Bennett · Nick Wilson · Alistair Woodward ·

    The New Zealand medical journal 06/2015; 128(1414):66-68.
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    ABSTRACT: The social and financial burden of road traffic injury in New Zealand is high compared with many other developed countries. In addition, the population is affected by chronic diseases such as obesity, diabetes and cardiovascular disease, all of which share physical inactivity as a risk factor. Road safety is currently a major objective of transport policy, while other public health outcomes are often ignored. There is a need to better understand the integrated outcomes that may arise from neighbourhood streets and routes that facilitate active travel through evidence-based design.
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    ABSTRACT: There is increased interest in the effectiveness and cobenefits of measures to promote walking and cycling, including health gains from increased physical activity and reductions in fossil fuel use and vehicle emissions. This paper analyses the changes in walking and cycling in two New Zealand cities that accompanied public investment in infrastructure married with programmes to encourage active travel. Using a quasi-experimental two-group pre-post study design, we estimated changes in travel behaviour from baseline in 2011 to mid-programme in 2012, and postprogramme in 2013. The intervention and control cities were matched in terms of sociodemographic variables and baseline levels of walking and cycling. A face-to-face survey obtained information on walking and cycling. We also drew from the New Zealand Travel Survey, a national ongoing survey of travel behaviour, which was conducted in the study areas. Estimates from the two surveys were combined using meta-analysis techniques. The trips and physical activity were evaluated. Relative to the control cities, the odds of trips being by active modes (walking or cycling) increased by 37% (95% CI 8% to 73%) in the intervention cities between baseline and postintervention. The net proportion of trips made by active modes increased by about 30%. In terms of physical activity levels, there was little evidence of an overall change. Comparing the intervention cities with the matched controls, we found substantial changes in walking and cycling, and conclude that the improvements in infrastructure and associated programmes appear to have successfully arrested the general decline in active mode use evident in recent years. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    Journal of epidemiology and community health 06/2015; DOI:10.1136/jech-2015-205466 · 3.50 Impact Factor
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    ABSTRACT: Designing walking and cycling back into urban communities may be most effective at achieving a sustained shift from car trips to walking and cycling. Such a shift could deliver substantial benefits for mitigating climate change, public health, social and health inequities, and economic resilience. There is a lack of robust evidence about what designs successfully result in these integrated benefits and are generalizable.
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    Alistair Woodward · Tony Blakely ·

    Australian and New Zealand Journal of Public Health 02/2015; 39(1). DOI:10.1111/1753-6405.12357 · 1.98 Impact Factor
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    Alistair Woodward · Sandar Tin Tin · Rob N Doughty · Shanthi Ameratunga ·
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    ABSTRACT: Background Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia, and the incidence of AF is increased markedly among elite athletes. It is not clear how lesser levels of physical activity in the general population influence AF. We asked whether participation in the Taupo Cycle Challenge was associated with increased hospital admissions due to AF, and within the cohort, whether admissions for AF were related to frequency and intensity of cycling.Methods Participants in the 2006 Lake Taupo Cycle Challenge, New Zealand¿s largest mass cycling event, were invited to complete an on-line questionnaire. Those who agreed (n¿=¿2590, response rate¿=¿43.1%) were followed up by record linkage via the National Minimum Health Database from December 1 2006 until June 30 2013, to identify admissions to hospital due to AF.ResultsThe age and gender standardized admission rate for AF was similar in the Taupo cohort (19.60 per 10,000 per year) and the national population over the same period (2006-2011) (19.45 per 10,000 per year). Within the study cohort (men only), for every additional hour spent cycling per week the risk changed by 0.90 (95% confidence interval 0.79 ¿ 1.01). This result did not change appreciably after adjustment for age and height.Conclusions Hospital admission due to AF was not increased above the national rate in this group of non-elite cyclists, and within the group the rate of AF did not increase with amount of cycling. The level of activity undertaken by this cohort of cyclists was, on average, not sufficient to increase the risk of hospitalization for AF.
    BMC Public Health 01/2015; 15(1):23. DOI:10.1186/s12889-014-1341-6 · 2.26 Impact Factor
  • Hayley Bennett · Rhys Jones · Gay Keating · Alistair Woodward · Simon Hales · Scott Metcalfe ·
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    ABSTRACT: Human-caused climate change poses an increasingly serious and urgent threat to health and health equity. Under all the climate projections reported in the recent Intergovernmental Panel on Climate Change assessment, New Zealand will experience direct impacts, biologically mediated impacts, and socially mediated impacts on health. These will disproportionately affect populations that already experience disadvantage and poorer health. Without rapid global action to reduce greenhouse gas emissions (particularly from fossil fuels), the world will breach its carbon budget and may experience high levels of warming (land temperatures on average 4-7 degrees Celsius higher by 2100). This level of climate change would threaten the habitability of some parts of the world because of extreme weather, limits on working outdoors, and severely reduced food production. However, well-planned action to reduce greenhouse gas emissions could bring about substantial benefits to health, and help New Zealand tackle its costly burden of health inequity and chronic disease.
    The New Zealand medical journal 12/2014; 127(1406):16-31.
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    Alistair Woodward ·

    Bulletin of the World Health Organisation 11/2014; 92(11):774. DOI:10.2471/BLT.14.148130 · 5.09 Impact Factor
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    Andy Haines · Kristie L Ebi · Kirk R Smith · Alistair Woodward ·

    The Lancet 09/2014; 384(9948):1073–1075. DOI:10.1016/S0140-6736(14)61659-7 · 45.22 Impact Factor
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    ABSTRACT: Background Policy advisers are seeking robust evidence on the effectiveness of measures, such as promoting walking and cycling, that potentially offer multiple benefits, including enhanced health through physical activity, alongside reductions in energy use, traffic congestion and carbon emissions. This paper outlines the ‘ACTIVE’ study, designed to test whether the Model Communities Programme in two New Zealand cities is increasing walking and cycling. The intervention consists of the introduction of cycle and walkway infrastructure, along with measures to encourage active travel. This paper focuses on the rationale for our chosen study design and methods. Method The study design is multi-level and quasi-experimental, with two intervention and two control cities. Baseline measures were taken in 2011 and follow-up measures in 2012 and 2013. Our face-to-face surveys measured walking and cycling, but also awareness, attitudes and habits. We measured explanatory and confounding factors for mode choice, including socio-demographic and well-being variables. Data collected from the same households on either two or three occasions will be analysed using multi-level models that take account of clustering at the household and individual levels. A cost-benefit analysis will also be undertaken, using our estimates of carbon savings from mode shifts. The matching of the intervention and control cities was quite close in terms of socio-demographic variables, including ethnicity, and baseline levels of walking and cycling. Discussion This multidisciplinary study provides a strong design for evaluating an intervention to increase walking and cycling in a developed country with relatively low baseline levels of active travel. Its strengths include the use of data from control cities as well as intervention cities, an extended evaluation period with a reasonable response rate from a random community survey and the availability of instrumental variables for sensitivity analyses.
    BMC Public Health 09/2014; 14(1):935. DOI:10.1186/1471-2458-14-935 · 2.26 Impact Factor
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    Sandar Tin Tin · Alistair Woodward · Shanthi Ameratunga ·
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    ABSTRACT: Background: Bicycle use, despite its proven health and other benefits, is rarely part of everyday travel for many people due to the perceived risk of injury from collision crashes. This article investigated the role of physical vs. attention conspicuity in preventing bicycle crashes involving a motor vehicle in New Zealand. Methods: The Taupo Bicycle Study involved 2590 adult cyclists recruited in 2006 (43.1% response rate) and followed for bicycle crash outcomes through linkage to four national databases. A composite measure of physical conspicuity was created using latent class analysis based on the use of fluorescent colours, lights and reflective materials, and the main colour of top, helmet and bike frame. Attention conspicuity was assessed based on regional differences in travel patterns and the amount of riding in a bunch. Cox regression modelling for repeated events was performed with multivariate adjustments. Results: During a median follow-up period of 6.4 years, 162 participants experienced 187 bicycle-motor vehicle crashes. The crash risk was not predicted by the four latent classes identified and the amount of bunch riding but was higher in Auckland, the region with the lowest level of bicycle use relative to car use. In subgroup analyses, compared to other latent classes, the most physically conspicuous group had a higher risk in Auckland but a lower risk in other regions. Conclusion: Conspicuity aids may not be effective in preventing bicycle-motor vehicle crashes in New Zealand, particularly in Auckland, where attention conspicuity is low.
    The European Journal of Public Health 07/2014; 25(3). DOI:10.1093/eurpub/cku117 · 2.59 Impact Factor
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    Li Bai · Cirendunzhu · Alistair Woodward · Dawa · Xiraoruodeng · Qiyong Liu ·
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    ABSTRACT: Background Tibet, with an average altitude of more than 4,000 meters, is warming faster than anywhere else in China. However, there have been no studies in Tibet of the relation between ambient temperature and mortality. Methods We examined mean temperature and daily mortality in three Tibetan counties (Chengguan, Jiangzi and Naidong) using a distributed lag non-linear model (DLNM) based on 5,610 deaths that occurred in 2008–2012. We separately investigated hot and cold effects on non-accidental deaths, cardiovascular deaths, out-of-hospital deaths and vulnerability factors including age, sex and education. Results In all three counties, the effect of heat tended to be immediate, while the impact of cold lasted longer. The effects were consistent but modest in size and not statistically significant except for cumulative cold effects in Jiangzi (lag = 0–14, RR = 2.251, 95% CI = 1.054–4.849). Those who were more vulnerable to temperature extremes tended to be men, the elderly (over 65 years) and illiterate persons. We found stronger temperature effects on cardiovascular deaths than on all-cause mortality, and we also observed an increase in out-of-hospital mortality in one county. Conclusions This is the first study to investigate the temperature–mortality relationship in Tibet, and the findings may guide public health programs and other interventions to protect the population against extreme temperatures in a developing Tibet.
    Science of The Total Environment 07/2014; s 485–486(1):41–48. DOI:10.1016/j.scitotenv.2014.02.094 · 4.10 Impact Factor
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    Li Bai · Cirendunzhu · Alistair Woodward · Dawa · Zhaxisangmu · Bin Chen · Qiyong Liu ·
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    ABSTRACT: Tibet of China, with an average altitude of over 4000m, has experienced noticeable changes in its climate over the last 50years. The association between temperature and morbidity (most commonly represented by hospital admissions) has been documented mainly in developed countries. Little is known about patterns in China; nor have the health effects of temperature variations been closely studied in highland areas, worldwide.
    Science of The Total Environment 06/2014; 490C:838-848. DOI:10.1016/j.scitotenv.2014.05.024 · 4.10 Impact Factor
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    Lachlan McIver · Alistair Woodward · Seren Davies · Tebikau Tibwe · Steven Iddings ·
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    ABSTRACT: Kiribati-a low-lying, resource-poor Pacific atoll nation-is one of the most vulnerable countries in the World to the impacts of climate change, including the likely detrimental effects on human health. We describe the preparation of a climate change and health adaptation plan for Kiribati carried out by the World Health Organization and the Kiribati Ministry of Health and Medical Services, including an assessment of risks to health, sources of vulnerability and suggestions for highest priority adaptation responses. This paper identifies advantages and disadvantages in the process that was followed, lays out a future direction of climate change and health adaptation work in Kiribati, and proposes lessons that may be applicable to other small, developing island nations as they prepare for and adapt to the impacts of climate change on health.
    International Journal of Environmental Research and Public Health 05/2014; 11(5):5224-40. DOI:10.3390/ijerph110505224 · 2.06 Impact Factor
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    ABSTRACT: Human leptospirosis is an emerging infectious disease of global significance, and is endemic to several countries in the Pacific. Zoonotic transmission dynamics combined with diagnostic challenges lead to difficulties in prevention and identification of cases. The Federated States of Micronesia (FSM) lacks surveillance data for human leptospirosis. This hospital-based serologic survey sought to estimate the burden of leptospirosis, collect information relating to associated factors, and assess the leptospirosis point-of-care rapid diagnostic test (RDT) commonly used in FSM. A four-month hospital-based survey was conducted in Pohnpei State, FSM in 2011. Patients with undifferentiated fevers presenting to hospital were referred for enrolment by physicians. Consenting participants provided paired blood specimens 10-30 days apart, and responded to interview questions regarding demographics, clinical symptoms, exposure to animals, and environmental exposure. Blood samples were subjected to immunochromatographic RDT and confirmed by microscopic agglutination test (MAT). Of 54 participants tested by MAT, 20.4% (95% confidence interval [CI] 10.1-30.6%) showed serologic evidence of acute infection. Occupation student (odds ratio [OR], 17.5; 95% CI: 1.9-161.1) and recreational gardening (OR, 8.6; 95% CI: 1.0-73.8), identified by univariate logistic regression, were associated with infection. The local rapid diagnostic test (RDT) performed with a sensitivity of 69.2 (42.3-89.3 CI) and specificity of 90.0 (81.6-95.6 CI) compared to MAT. This study demonstrated a high burden of leptospirosis in Pohnpei. Further work is warranted to identify additional risk factors and opportunities to control leptospirosis in Pohnpei and other Pacific settings.
    BMC Infectious Diseases 04/2014; 14(1):186. DOI:10.1186/1471-2334-14-186 · 2.61 Impact Factor
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    ABSTRACT: ABSTRACT: The Intergovernmental Panel on Climate Change (IPCC) released its latest report on March 31, 2014. This report was the second instalment of the Fifth Assessment Report, prepared by Working Group 2, on impacts, vulnerability, and adaptation to climate change. In this Comment, we, as contributors to the chapter on human health, explain how the IPCC report was prepared and highlight important findings.
    The Lancet 04/2014; 383(9924):1185-9. DOI:10.1016/S0140-6736(14)60576-6 · 45.22 Impact Factor
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    [Show abstract] [Hide abstract]
    ABSTRACT: The Intergovernmental Panel on Climate Change (IPCC) released its latest report on March 31, 2014. This report was the second instalment of the Fifth Assessment Report, prepared by Working Group 2, on impacts, vulnerability, and adaptation to climate change. In this Comment, we, as contributors to the chapter on human health, explain how the IPCC report was prepared and highlight important findings.
    The Lancet 04/2014; · 45.22 Impact Factor

Publication Stats

3k Citations
728.90 Total Impact Points


  • 1924-2015
    • University of Auckland
      • • School of Population Health
      • • Section of Epidemiology and Biostatistics
      Окленд, Auckland, New Zealand
  • 2009
    • Health New Zealand
      Christchurch, Canterbury, New Zealand
  • 1999-2008
    • University of Otago
      • • Department of Public Health (Wellington)
      • • Wellington School of Medicine and Health Sciences
      • • Department of Medicine (Wellington)
      Taieri, Otago, New Zealand
    • Wellington Hospital
      Веллингтон, England, United Kingdom
  • 2005
    • Australian National University
      Canberra, Australian Capital Territory, Australia