Journal of Transport & Health Volume 2, Issue 2, June 2015

Inside Front Cover

The impacts of national and local government actions on active travel
Jennifer S. Mindell

Editorial: Themed section on the geographies of active travel
Seraphim Alvanides

Further examinations of mobility in later life and improving health and wellbeing
Charles Musselwhite


Research is needed to examine how to improve mobility in later life. Research in this section of the special issue suggests that pet ownership, proximity to amenities and culture are associated with older people walking more. Two popular emerging technologies are examined including, mobility scooters and e-bikes and the potential for them to enable mobility, along with barriers to use are included.

With regards to driving, there is further evidence that self-regulation planning and implementation intentions may help older drivers achieve their mobility goals and promote safer driving across the lifecourse. In addition, to help older people stay on the roads, support from medical experts is welcomed, though evidence here suggests medical professionals are not always confident to supply it.

In conclusion, there is a need to look at the wider relationship between mobility, ageing and health embracing a transdisciplinary and intergenerational approach.

Social inequalities in transport: Going beyond the evidence
Carme Borrell

The development of policy-relevant transport indicators to monitor health behaviours and outcomes
Hannah Badland, Suzanne Mavoa, Karen Villanueva, Rebecca Roberts, Melanie Davern, Billie Giles-Corti


  • Transport spatial indicators are needed to monitor health and inform planning
  • Spatial indicators can compare of health outcomes with area-level transport variations
  • There is potential to up-scale the most predictive indicators to national measures

Linking transport, health and sustainability: Better data sets for better policy-making
Clemence Cavoli, Nicola Christie, Jennifer Mindell, Helena Titheridge


  • Gaps in national datasets were identified, which limit research and policy making.
  • A need for further datasets linking transport, health and sustainability was found.
  • The need for new data in the field of active travel and health was highlighted.
  • Suggested solutions include applying data fusion to existing datasets.

Air pollution and health – The views of policy makers, planners, public and private sector on barriers and incentives for change
Jackie Hyland, Peter Donnelly


  • Traffic volume and urban air quality has not improved in recent years.
  • There is a disconnect between planning and development priorities.
  • Vehicular transport is still the most efficient and cost effective option.
  • Public understanding of the links between air pollution and health is limited.
  • Real time air pollution and health impact information should be made available.

Health and transportation: Small scale area association
Mehran Fasihozaman Langerudi, Mohammadian Abolfazl (Kouros), P.S. Sriraj


  • A methodology is developed to disaggregate county-level health data.
  • We have proposed built environment-related individual health condition models.
  • Iterative Proportional Fitting (IPF) approach can be used to disaggregate different data sources.

Bikeshare’s impact on active travel: Evidence from the United States, Great Britain, and Australia
Elliot Fishman, Simon Washington, Narelle Haworth


  • Estimates changes in active transport levels due to bikeshare.
  • Multi-city analysis using trip data and transfers from previously used mode to bikeshare.
  • Bikeshare reduces physical activity when it replaces walking.
  • Overall, bikeshare increases levels of active travel.
  • Encouraging a shift from sedentary modes to bikeshare enhances health contribution.

Changes in travel to school patterns among children and adolescents in the São Paulo Metropolitan Area, Brazil, 1997–2007
Thiago Hérick de Sá, Leandro Martin Totaro Garcia, Grégore Iven Mielke, Fabiana Maluf Rabacow, Leandro Fórnias Machado de Rezende


  • Use of active and public transport in school travel declined between 1997 and 2007.
  • Use and time of private transport in school travel increased in the same period.
  • Changes were more pronounced among children (6–11 years old).
  • Policies that encourage active and safe transport to school are needed.

How actively do children travel to their pre-school setting?
Liz Oxford, Jon Pollock


  • Parents completed a questionnaire at four pre-schools on travel arrangements.
  • Prevalence of children’s active travel varied at each pre-school.
  • Children who lived nearer the pre-school were more likely to travel actively.
  • Distance to pre-school, weather and commitments independently predicted active travel.

Don’t learn safety by accident: A survey of child safety restraint usage among drivers in Dansoman, Accra
Enoch F. Sam


  • The study revealed low child restraints use among drivers in Dansoman, Accra.
  • Children in new vehicles are more likely to be restrained.
  • Children seated in the back seat are more likely to be unrestrained.
  • Children are more likely to be unrestrained where there are other occupants.

Rural–urban differences in health care provider child passenger safety anticipatory guidance provision
Andrea L. Huseth-Zosel, Megan Orr


  • Health care provider (HCP) child passenger safety (CPS) advice provision was gaged.
  • HCPs in several upper Midwest states were surveyed about CPS advice provision.
  • Rural HCPs were less likely than urban HCPs to provide CPS counseling to parents.
  • Rural/urban differences exist in HCP confidence in ability to provide CPS counseling.

Stress, adrenaline, and fatigue contributing to at-fault collision risk: Quantitative and qualitative measures of driving after gambling
Alissa M. Greer, Scott Macdonald, Robert E. Mann


  • The relationship between gambling and collisions was examined.
  • Adverse gambling effects on driving significantly increased lifetime “at fault” collisions.
  • Major mechanisms from gambling were identified as potential risk factors for collisions, including emotional stress and fatigue.

Epidemiology and spatial examination of bicycle-motor vehicle crashes in Iowa, 2001–2011
Cara J. Hamann, Corinne Peek-Asa, Charles F. Lynch, Marizen Ramirez, Paul Hanley


  • BMV crash locations vary by person, crash, and environmental factors.
  • Rural BMV crashes are more common at non-intersections than intersections.
  • Child bicyclists (<10) are more likely to be in non-intersection BMV crashes.
  • Iowa BMV crashes occur more frequently in low income and education areas.
  • Iowa BMV crash characteristics are similar to those in densely populated U.S. areas.

Risk factors for cycling accident related injury: The UK Cycling for Health Survey
Milo A. Hollingworth, Alice J.L. Harper, Mark Hamer


  • Cycling is increasing in popularity.
  • Injuries related to cycling accidents have increased.
  • The major risk factor for a cycling accident was weekly cycling distance.
  • Nearly half of all cycling injuries required medical attention.

Interactions between psychological and environmental characteristics and their impacts on walking
Yong Yang


Due to walking׳s benefits to physical and mental health as well as to environmental and economic sustainability, numerous studies have examined psychological and environmental characteristics on their impacts on walking. However, understanding of how the interactions between psychological and environmental characteristics influence walking remains limited. Recently, both competitive mechanism and synergetic mechanism have been proposed, and a number of empirical studies have examined the interactions between psychological and environmental characteristics, but the results were inconsistent.

We reviewed 11 recent studies and discussed their difference in terms of studies population, outcomes, environmental characteristics, and psychological characteristics. We propose a framework that integrate both mechanisms and provides an explanation to the inconsistency. More important, the framework may stimulate further empirical researches and provide implications for policy intervention to promote walking.

 Sociospatial patterning of the use of new transport infrastructure: Walking, cycling and bus travel on the Cambridgeshire guided busway
Eva Heinen, Jenna Panter, Alice Dalton, Andy Jones, David Ogilvie


  • New infrastructure may promote active travel and thereby contribute to health gain.
  • A new guided busway and service path attracted walkers, cyclists and bus users.
  • Use was determined by residential proximity to the intervention.
  • Proximity was a stronger predictor of use for cycling than for walking or bus use.
  • The effect of proximity was stronger in the population living outside urban areas.

Choice of commuting mode among employees: Do home neighborhood environment, worksite neighborhood environment, and worksite policy and supports matter?
Lin Yang, J. Aaron Hipp, Deepti Adlakha, Christine M. Marx, Rachel G. Tabak, Ross C. Brownson


  • 11.1% of employed Missourians commute to work via active commuting.
  • A transit stop within 15 minutes of home increases public transit commuting.
  • Worksite incentives to use public transit significantly increase use.
  • Employees actively commute when they live near worksites with cycling facilities.
  • Low cost recreation facilities near worksites are associated with active commuting.

Are GIS-modelled routes a useful proxy for the actual routes followed by commuters?
Alice M. Dalton, Andrew P. Jones, Jenna Panter, David Ogilvie


  • 276 GPS-tracked commute trips from a free-living sample of adults were analysed.
  • GPS routes were compared with GIS-modelled shortest routes.
  • GIS may be acceptable for distance estimation for active commuting.
  • GPS should be used to obtain accurate estimates of environmental contexts.
  • Method chosen will likely influence conclusions on health implications of commuting.

Children׳s experiences: Enjoyment and fun as additional encouragement for walking to school
Vivian Romero


  • Children are active creators of their travel experiences and such experiences are worthy of study.
  • Walking to school embeds developmental capabilities when viewed as a fun experience.
  • Certain neighbourhood attributes contribute to sensory, playful, autonomous and social experiences as children walk.

Where does bicycling for health happen? Analysing volunteered geographic information through place and plexus
Greg P. Griffin, Junfeng Jiao


  • Crowdsourcing active transport volumes provide larger datasets than previously available.
  • Bicycling for fitness is positively associated with steep terrain; whereas utilitarian bicycle trips avoid steep slopes.
  • Geographically weighted regression improved model fit by controlling for spatial autocorrelation.
  • Both place-based and roadway network variables are important considerations for understanding the geography of bicycling.

Associations between the objective and perceived built environment and bicycling for transportation
Liang Ma, Jennifer Dill


  • Different factors are associated with bicycling propensity and bicycling frequency.
  • The perceived and objective environments have different associations with bicycling.
  • Interventions to improve both actual environment and perceptions are necessary.
  • Interventions to encourage positive attitudes on bicycling are necessary.

Travel behavior of low income older adults and implementation of an accessibility calculator

Md Moniruzzaman, Anna Chudyk, Antonio Páez, Meghan Winters, Joanie Sims-Gould, Heather McKay


  • Travel behavior of lower income older adults was investigated.
  • Multilevel model was used to investigate trip distance behavior.
  • Interaction of dog ownership and walking had a positive association with trip length.
  • Web-based application was implemented to calculate accessibility score (A-score).
  • A-score along with surrounding opportunity landscape determines walkability.

The impact of mobility scooters on their users. Does their usage help or hinder?:A state of the art review
Roselle Thoreau


  • Research literature surrounding mobility scooters is sparse.
  • Scooter users feel their scooter has a positive impact on their life.
  • Scooter training is seen as important but this does not always occur.
  • The impacts of scooter use on health, in the short term, are not detrimental.
  • The long-term links between scooter usage and physical functionality is unclear.

Extending life on the bike: Electric bike use by older Australians
Marilyn Johnson, Geoff Rose


  • An online survey of older electric bike riders in Australia.
  • Majority of electric bike owners rode weekly (88.0%) including daily riders (34.3%).
  • Infrequent adult pedal cyclists used their e-bike frequently for all trip types.
  • Encouraging e-bikes will help older people make active transport choices for longer.
  • We recommend age exceptions to permit cycling on footpaths from 65 years.

General practitioner attitudes and practices in medical fitness to drive in Ireland

Amila Kahvedžić, Regina McFadden, Gerry Cummins, David Carr, Desmond O’Neil


  • We investigated attitudes, resources and practices towards medical fitness to drive.
  • We surveyed Irish family doctors by questionnaire.
  • A majority was confident or very confident in assessing medical fitness to drive.
  • A majority expressed ambivalence about primary responsibility for such assessments.
  • There were high levels of awareness of supporting literature on driving and health.

An intervention encouraging planned self-regulation and goal setting in drivers across the lifespan: Testing an extended theory of planned behaviour
Holly Gwyther, Carol Holland


  • Planned driving self-regulation may be more adaptive than avoidance strategies.
  • A theory of planned behaviour (TPB) intervention was conducted in drivers (18–83 years).
  • The intervention did not result in change to TPB components addressed.
  • 93% of intervention participants achieved their first goal to extend their driving safely.
  • Variance in goal achievement was predicted by self-regulation indices and TPB constructs.

Age-friendly mobilities: A transdisciplinary and intergenerational perspective
Lesley Murray


  • Uses WHO Age-friendly policy to reveal a series of questions about age-friendliness.
  • Argues older people’s mobilities are dependent on the mobilities of people of all ages.
  • Contends that this issue benefits from transdisciplinary and intergenerational perspectives.

Bus use in a developing world city: Implications for the health and well-being of older passengers
Carlos Aceves-González, Sharon Cook, Andrew May


  • Accessible public transport is important for a healthy and active older population.
  • Driver behaviour and poor bus design present considerable issues for older passengers.
  • There are perceived and actual barriers relating to safety, usability and comfort.
  • Good public transport design must consider the whole door-to-door journey.
  • Focus groups and passenger observations provide highly complementary data.
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Changing Urban speed limit to 20mph

Go_20mph_reportGo towards changing the default urban speed limit to 20mph

A report has been produced by Blake (the road and safety charity) exploring the current evidence on 20mph speed limits and their effects on the pedestrians and cyclists.

While Britain has one of the best road safety records in Europe, per mile travelled, you are more likely to be killed on foot or bicycle than in many of our European neighbours.

If Britain walked and cycled as much as people in Sweden or the Netherlands, Britain would fall down the road safety rankings significantly. In other words, our road safety record is skewed by the fact that so few people walk and cycle compared to other countries.

Surveys indicate that danger from traffic is one of the main factors preventing families and commuters from walking and cycling. Britain also ranks among the lowest in Europe in terms of how well people know others in the local area.

This way there is much more that can be done to improve safety for pedestrians and cyclists, both to reduce casualties and enable more people to use these non-harmful, non-polluting, sociable and affordable modes of travel.

Key findings

  • Reducing the default speed limit from 30mph to 20mph across Britain would have a significant and meaningful impact in reducing crashes and serious injuries. Pedestrian and cyclist safety would particularly benefit.
  • As a worst-case scenario, it is reasonable to expect a 1mph reduction of average speeds with an associated 6% reduction in crashes and collisions in these areas.
  • It is reasonable to expect that reducing the default limit from 30mph to 20mph could aid wider efforts to encourage active and sustainable travel, and therefore help deliver significant health, wellbeing and environmental benefits.
  • The guidance provided by central government to local authorities on 20mph limits, while giving the councils the opportunity to introduce widespread 20mph
  • limits, does not show the leadership to make broader changes, and certain elements pose a significant barrier to some local authorities moving towards area-wide 20mph limits. This contributes to the implementation of 20mph limits across councils being mixed.
  • There are still unnecessary costs associated with local authorities implementing 20mph limits at local level (as opposed to a national change in the default limit), especially related to present signage regulations.

Full report click here

Original source Learning for Public Health West Midlands

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Fifth Regional Seminar on Active Travel

Fifth Regional Seminar on Active Travel
Active Travel – Better Towns Ride the Lights, Walk the Prom
co-hosted by Living Streets and North West Active Travel Network

Venue: The Solaris Centre, Blackpool

Wednesday 14 October 2015

The Speakers will include

Nick Davies (University of Central Lancashire) Economic benefits of active travel

Nick Cavill (Consultant) Health benefits of active travel

Tom Platt (Head of Policy, Living Streets) Walkable places – Current developments

Karen Stevens (Liverpool City Council) Bike Hire Schemes

Andy Howard (Transport for Greater Manchester) CCAG – Towards Velocity 2025

Jon Little (Waltham Forest Council) The Waltham Forrest Mini-Holland

Steve Essex (Transport Initiatives) Pedestrian-cycle interactions

Latif Patel (Blackpool Council) Crossings and signals phases at junction

Prior to the formal programme optional cycling and walking tours will be available from Blackpool North Station visiting sites of special traffic interest en route to the Solaris Centre

Lunch will be provided by Café Chicco at the Solaris Centre.


Standard: £50
Representatives of voluntary bodies: £25

Bookings can be registered at :

Deadline: Monday 5th October


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Health and Transportation: Small scale area association

Journal of Transport & Health Volume 2, Issue 2, June 2015

Health and transportation: Small scale area association
Mehran Fasihozaman Langerudi, Mohammadian Abolfazl (Kouros), P.S. Sriraj


  • A methodology is developed to disaggregate county-level health data.
  • We have proposed built environment-related individual health condition models.
  • Iterative Proportional Fitting (IPF) approach can be used to disaggregate different data sources.


Public health, as a major factor influencing the livability and well-being of a community has been a subject of interest in many academic fields. It is postulated that public health has strong correlations with various factors including land development, urban form, and transportation system elements. However, due to scarcity of individual level and confidential health data, such analysis has been typically conducted in an aggregate level resulting in less accurate results due to aggregation bias. In this paper, a methodology is developed and applied to disaggregate an individual-level health data in county scale into smaller geography by using an iterative proportional fitting approach while maintaining the marginal distributions of the controlled variables. Then, the disaggregated data is used to estimate various models of individual health condition as a function of socio-demographic, built environment, and transportation system attributes. It is noteworthy that the proposed approach can be applied to disaggregate any aggregate data in an efficient way.

Free access click here

Origanal source SPAHG

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Journal of Transport & Health Volume 2, Issue 1, March 2015 -Transport, travel and mobility in later life

The role of transport and mobility in the health of older people
Charles Musselwhite, Carol Holland, Ian Walker

The world’s population is ageing. Older people are healthier and more active than previous generations. Living in a hypermobile world, people want to stay connected to dispersed communities as they age.

Staying connected to communities and social networks enables older people to contribute and connect with society and is associated with positive mental and physical health, facilitating independence and physical activity while reducing social isolation. Changes in physiology and cognition associated with later life mean longer journeys may have to be curtailed. A shift in focus is needed to fully explore older people, transport and health; a need to be multidisciplinary in approach and to embrace social sciences and arts and humanities.

A need to embrace different types of mobilities is needed for a full understanding of ageing, transport and health, moving from literal or corporeal through virtual and potential to imaginative mobility, taking into account aspirations and emotions. Mobility in later life is more than a means of getting to destinations and includes more affective or emotive associations. Cycling and walking are facilitated not just by improving safety but through social and cultural norms.

Car driving can be continued safely in later life if people make appropriate and informed decisions about when and how to stop driving; stringent testing of driver ability and skill has as yet had little effect on safety. Bus use facilitates physical activity and keeps people connected but there are concerns for the future viability of buses. The future of transport may be more community led and involve more sharing of transport modes.

Improving accessibility for older people – Investing in a valuable asset 

Roger Mackett


  • Older people make a significant economic contribution to society.
  • Improving their access would enable them to increase their contribution.
  • The policy of free off-peak bus travel for older people in Britain is a good example.
  • The economic contribution of older people to society will increase in future.


This paper explores the contribution of older people to society, the role of mobility in the quality of life of older people, and whether making it easier for older people to travel would enable them to increase their contribution.

The paper commences by considering evidence on the economic value of older people to society. This shows that older people make a net contribution through expenditure in shops, employment, voluntary work, childcare and taxation which exceeds their cost to the taxpayer. The assumptions underlying the calculations are examined and found to be robust. The patterns of travel of older people are examined and found to be consistent with the estimates of the economic contribution of older people.

Mobility provides many intrinsic benefits for older people, facilitating independence, reducing social isolation and physical activity. Evidence from the examples of the ability to drive and providing free bus travel is considered. Then the contribution of older people to society in future is examined and how travel contributes to this. It is shown that changes in older people׳s mobility would affect their contribution to society. Ways in which the mobility of older people could be increased are identified.

Different types of out-of-home activities and well-being amongst urban residing old persons with mobility impediments
Anu Siren, Randi Hjorthol, Lena Levin


  • Two activity types were examined: ‘utilitarian’ and ‘discretionary’ activities.
  • Both activity types contributed to well-being by representing different sides of being.
  • Utilitarian activities were important in maintaining independence and fulfilling basal needs.
  • Discretionary activities were important in existing in relation to the surroundings.


Independent mobility has been proposed to be a precondition for leading an independent, non-institutionalized life. Supporting independent mobility for the growing senior segment thus has societal importance. The question of how to maintain well-being through mobility in older age is, however, a complex one.

The present study explicates this by focusing on how utilitarian and discretionary activities—representing different types out-of-home activities—contribute to well-being, using data from individual interviews with persons aged 80–95, living in Copenhagen, Denmark. We structured the material by the two activity types and found both to contribute to participants׳ well-being by representing different sides of ‘being’. Utilitarian activities were important in maintaining independence and fulfilling basic needs, while discretionary activities were important for the individual existing in relation to the surroundings.

Mobility-related well-being appears constructed both through independent separateness and through sense of community. This finding implies that supporting mobility in the sense of mere fulfilment of basic needs may not be enough.

Managing the safe mobility of older road users: How to cope with their diversity?

Claude Marin-Lamellet, Sonja Haustein


  • Practices to manage the safe mobility of older road users were reviewed.
  • 29 good practice examples in 6 categories were identified.
  • Practices were matched with the needs of different segments of older people.
  • Current practices are not targeted to the user groups that would benefit most.
  • Areas that are not covered by existing practices were identified.


Against the background of an ageing population, the management of older people׳s safe mobility is becoming an increasingly important issue. Mobility is vital for older people׳s quality of life and several examples of good practice that support older people׳s safe mobility already exist. However, the older population is increasingly diverse and its different segments have different mobility needs and expectations.

This paper has reviewed practices to manage older people׳s safe mobility and identified 29 examples of good practice which fall into six categories. The different kinds of practices were assessed with regard to their suitability for different segments of the older population as identified in previous studies. In addition, we considered whether the needs of certain segments remain unmet.

Our study found that most practices target individuals with mobility restrictions and mainly attract groups who are already users and improve their (safe) use of the preferred transport mode. However, they do not seem to succeed in increasing mobility options, e.g. by encouraging car-reliant users to cycle or use public transport or by helping older women to continue to drive. We advise that existing practices should more directly target those segments that would benefit from them the most and be adapted more specifically to these segments׳ needs and preferences.

We have identified a complete failure to provide awareness programs to inform older users about the potential benefits of driver assistance systems, a lack of programmes to increase perceived security, as well as a comprehensive scheme for older drivers who have to stop driving.

Potential impacts of subsidised bus travel for older people
Anthony A. Laverty, Christopher Millett


  • England has a national policy which enables persons over the age of 60 to travel free of charge on buses.
  • The scheme is unusual internationally, and early evidence suggests the scheme may be linked to a number of benefits for older people.
  • Nonetheless, in the context of pressure on public spending, we need to know more about the cost-effectiveness of the scheme, and further research is warranted.


In this viewpoint we will reflect on the concessionary bus pass system in use in England and how this may affect the health and wellbeing of older persons. We will consider these issues in light of controversy over whether any benefits from such schemes can justify their costs.


Transit use and walking as potential mediators of the association between accessibility to services and amenities and social participation among urban-dwelling older adults: Insights from the VoisiNuAge study
Dominic Julien, Lucie Richard, Lise Gauvin, Michel Fournier, Yan Kestens, Bryna Shatenstein, Mark Daniel, Geneviève Mercille, Hélène Payette.


  • Two mediators of links between accessibility and social participation were tested.
  • Transit use mediated this association in multiple and separate mediation analyses.
  • Walking frequency was not a significant mediator in multiple mediation analyses.
  • Conflicting results were observed for separate mediation analyses involving walking.
  • Walking purposes were not measured, which may explain these mixed results.


Accessibility to services and amenities is related to social participation in older adults. However, the mechanisms underlying this association are not clear. Transit use and walking may be potential mediating variables.

The aim of this study was to investigate whether frequency of transit use and frequency of walking mediated the relationship between accessibility to services and amenities conducive to social participation (SACSP) and social participation itself among a sample of older adults.

Participants were 519 older adults from the VoisiNuAge study. Multiple mediation and separate mediation analyses were conducted to investigate whether frequency of transit use and frequency of walking mediated the association between accessibility to SACSP and social participation, controlling for sociodemographic variables. Results showed that transit use was a significant mediator in multiple and separate mediation analyses.

Walking frequency was not a significant mediator in multiple mediation analyses, and conflicting results were observed for separate mediation analyses involving walking. We conclude that the association between accessibility to SACSP and social participation seems to be partly mediated by transit use, but results involving walking should be interpreted cautiously.

Transportation mode usage and physical, mental and social functions in older Japanese adults

Kenji Tsunoda, Naruki Kitano, Yuko Kai, Taishi Tsuji, Yuki Soma, Takashi Jindo, Jieun Yoon, Tomohiro Okura.


  • About 50% and 10% of older adults seldom used bicycle and vehicles, respectively.
  • Bicycle and vehicle travel were positively associated with various health measures.
  • Older adults who stayed in walking areas were more likely to have poor health.



The purpose of this study was to cross-sectionally examine associations between frequencies of bicycle and motor vehicle travel, physical and mental statuses and social networks.


This study was conducted from 2009 to 2012 with 629 community-dwelling older adults (73.3±5.2 years old, female 53.7%) in Kasama City, Rural Japan. Travel status, physical activity scale for the elderly, Lubben social network scale and geriatric depression scale were collected via a self-administrated questionnaire. We also calculated a standardized physical function score through physical performance tests.


After adjusting for age, gender, education, living arrangement, body mass index and clinical history, we found a positive association between frequency of bicycle and motor vehicle travel and physical activity, social networks and mental status (Trend P<0.05). Physical function was also significantly associated with motor vehicle travel (Trend P<0.05). Additional analysis revealed that older adults who mainly stayed within a walking area were more likely to experience less physical activity and social networking and have diminished mental status and physical function (Trend P<0.05).


Extending the travel area through use of transportation modes might provide health benefits. Assessing transportation mode usage could improve screening and assistance strategies for people who are physically or mentally frail or lonely.

Destinations matter: The association between where older adults live and their travel behaviour

Anna M. Chudyk, Meghan Winters, Md Moniruzzaman, Maureen C. Ashe, Joanie Sims Gouldd Heather McKay.


Prospective travel diary data gathered on the seven-day travel behavior (destinations visited, trip frequency, purpose and mode) of older adults with low income.

  • Destinations most relevant to older adults were grocery stores, malls, restaurants/cafés.
  • Living in neighborhoods with a high prevalence of destinations may encourage older adults to walk more frequently.


The positive effect of physical activity in the prevention and treatment of many chronic diseases and age-related disabilities, such as mobility-disability, are widely accepted.

Mobility is broadly defined as the ability of individuals to move themselves within community environments. These two concepts – physical activity and mobility – are closely linked and together contribute to older adults living healthy, independent lives.

Neighborhood destinations may encourage mobility, as older adults typically leave their homes to travel to specific destinations. Thus, neighborhoods with a high prevalence of destinations may provide older adults an attractive opportunity to walk, instead of drive, and thereby obtain incidental physical activity.

We know surprisingly little about the specific types of destinations older adults deem relevant and even less about destinations that support the mobility of older adults with low income. Accessible neighborhood destinations may be especially important to older adults with low income as they are more likely to walk as a primary travel mode. Conversely, this population may also be at increased risk of functional impairments that negatively affect their ability to walk.

As a means to fill this information gap we aimed to better understand the mobility habits of older adults with low income. Thus, our specific objectives were to:

  • describe the types of destinations older adults with low income most commonly travel to in one week
  •  determine the association between the prevalence of neighborhood destinations and the number of transportation walking trips these individuals make (average per day).

We conducted a cross-sectional study of community-dwelling older adults with low income residing within Metro Vancouver, Canada. We assessed participant travel behavior (frequency, purpose, mode, destination) using seven-day travel diaries and measured the prevalence of neighborhood destinations using the Street Smart Walk Score. We also assessed participants’ sociodemographic characteristics and mobility (physical function, car access, confidence walking). We used a negative binomial model to determine the association between Street Smart Walk Score and number of transportation walking trips (average per day).

Our sample was comprised of 150 participants (median age 74 years; 51 men) from who we acquired at least one day of travel diary data (range=1–7 days). Participants made three trips per day (2, 5; median P25, P75) and travelled to six different destination types per week (5, 9; median P25, P75). Destinations most relevant to older adults were grocery stores, malls, and restaurants/cafés. Each 10-point increase in Street Smart Walk Score was associated with a 20% increase in the number of transportation walking trips (average per day, incidence rate ratio=1.20, 95% CI=1.12, 1.29).

Our findings provide preliminary evidence regarding destinations that may be most relevant to older adults. They also suggest that the prevalence of these neighborhood destinations may encourage walking. As we approach a new era of healthy city benchmarks, our findings guide policy makers and developers to retrofit and develop communities that support the mobility, health, and independence of older adults.

I grew up on a bike”: Cycling and older adults
Meghan Winters, Joanie Sims-Gould, Thea Franke, Heather McKay.


  •  Little cycling research has focused on the older adults, a rapidly growing population.
  •  Cycling rates were high for older adults who live in Downtown Vancouver, a bicycle-friendly area in Canada.
  •  Older adults identified safety, environment, social and history of activity as travel influences.


A large proportion of the growing population of older adults have low levels of physical activity and face ensuing health and mobility problems. Cycling is a health-promoting and widely accessible transportation option.

However, throughout North America cycling rates amongst older adults are extremely low. Evidence from European countries suggests that cycling for older adults is possible and can be a popular travel choice. Therefore, we aimed to assess factors that contribute to cycling trends amongst North American older adults.

We used a mixed methods approach to describe cycling behaviors, and facilitators and barriers to cycling in a highly bikeable area of Vancouver, Canada. We conducted a cross-sectional study of older adults (age ≥60 years) who lived in Vancouver’s downtown core. During September–October 2012, participants (n=191) recorded travel in 7-day diaries and completed questionnaires on cycling behaviors and perceptions of their neighborhood environments.

We conducted in depth interviews with a subset of older adults (n=27) to better understand how they travelled in and around their neighborhoods. Participants demonstrated relatively high levels of cycling; one in four participants reported cycling in a usual week.

Cycling mode share was 3.2% (182/5730 reported trips). Notably, this cycling mode share is three times higher than the mode share for older adults living in the region and double the mode share for the general (all-ages) population. Based on a framework analysis of the interviews, factors that facilitate cycling include supportive infrastructure, a history of activity and the social aspects of cycling.

Factors that were barriers to cycling, both amongst those who reported cycling and those who did not, focused on safety, including motor vehicle traffic, cyclist behavior and theft. Our results suggest that should favorable policy and environmental conditions exist, cycling as a form of active transportation may be a viable option for older adults.

Driving licences and medical screening in old age: Review of literature and European licensing policies
Anu Siren, Sonja Haustein


  • We investigate the evidence for and against having an age-based driver screening.
  • We map and compare the current driving licensing policies in EU countries.
  • We draw conclusions based on the literature and the policy mapping.
  • The benefits from age-based screening are unlikely to outweigh the disadvantages.
  • Many European policies are coercive and not evidence based.


Chronological age, per se, seems to be, in the case of mature drivers, only a weak predictor of safe driving performance. However, screening policies based on chronological age are widely used. Nevertheless, lately, more evidence-based policies have been called for.

In this paper we:

first, investigate the evidence for and against having an age-based driver screening policy in place

second, we map and compare the current driving licensing policies in European Union (EU) member states in order to examine the variation

third, we draw conclusions based on the literature and the policy mapping and provide policy recommendations.

We find no evidence from the literature demonstrating that the benefits from age-based driver screening would outweigh the disadvantages, and we find the European policies, to a large extent, coercive and not evidence based. Based on research evidence, the policies are likely to limit the mobility and potentially worsen the safety of older persons.

Understanding travel patterns to support safe active transport for older adults
Steve O׳Hern, Jennifer Oxley.


  • Identified characteristics of active transport use among older and younger adults.
  • Approximately one-fifth of trips involve active transport modes.
  • Are differences in travel needs, reasons for and time of travel.
  • Ways to improve participation in active transport and offer good mobility solutions for older adults are discussed.


Transport and mobility needs for all aged road users are diverse and may change with increasing age. With an increasing ageing population throughout much of the developed world combined with increasing life expectancies, there is a growing need to understand the transportation requirements of older adults. Moreover, while car use is still the most popular form of transport for older adults, alternative transport modes are offered and promoted, and their use is increasing.

This paper explores the characteristics of active transport usage among older adults, defined as persons over 65 years of age, in Melbourne, Australia. Data from the Victorian Integrated Survey of Travel Activity (VISTA) was analysed to undertake the assessment.

The analysis revealed that private motorised transport is the predominant mode of transport for older adults, representing approximately 70% of travel. Approximately 22% of travel was made using active transportation, with the majority of these being walking trips. Average trip distance, trip duration and walking speed were found to decrease past the age of 75 years.

The analysis shows that the travel patterns of older adults differ from those of younger adults which may reflect the fact that transitions in lifestyle influence their travel needs, destinations and time of travel, or an overall decrease in mobility. The implications of the findings are discussed in terms of ways to improve participation in active transportation and enhance the safe mobility of older active transport users, including a need to enhance the urban environment.

Future mobility in an ageing society – Where are we heading?
Ian Shergold, Glenn Lyons, Christa Hubers.


  • Assistive technologies influence where and how older people will live.
  • Scenario planning reveals plausible but divergent futures for older people.
  • Assistive technologies coupled with state support for care indirectly affect travel.
  • Shaping change rather than anticipating change may be a better policy response.


The demographic profile of UK society is changing as people live longer. Maintaining the wellbeing and quality of life of an ageing society is set to be extremely challenging.

To what extent can the state afford to meet a potentially burgeoning demand for social care?

  • What expectations will be placed upon informal carers to enable the system to cope?
  • In what ways and to what extent might assistive technologies have a part to play in supporting people both in terms of active ageing and in relation to coping with failing health?
  • Beyond these questions is one which is more explicitly pertinent to transport policy: how and where will older people live and how will this affect patterns of mobility and levels of travel demand?

This paper reports on a scenario planning exercise which has examined four different futures for living in later life, defined by considering two critical uncertainties: the extent to which older people in society engage with new healthcare technologies; and the extent to which the state provides care for people living in later life. The scenarios, explored with transport, ageing and assistive technology experts, serve to highlight how social practices may be shaped in very different ways both for older people and for those with whom they interact.

The paper goes on to examine the implications for future mobility – such as the role of the home as a trip attractor as well as a trip generator – as well as to explore the extent to which transport policymakers are equipped to address the uncertainties for the transport system of an ageing society.

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Is there evidence that walking groups have health benefits? A systematic review and meta-analysis

Is there evidence that walking groups have health benefits? A systematic review and meta-analysis

Sarah Hanson, Andy Jones
9 November 2014

Regular physical activity positively impacts health potentially offering similar effects to some drug interventions in terms of mortality benefits. Indeed, it has been suggested as an alternative or adjunct to conventional drug therapy. Walking at a pace of 3–5 m/h (5–8 km/h) expends sufficient energy to be classified as moderate intensity2 and is an easy and accessible way of meeting physical activity recommendations.

Systematic reviews and meta-analyses have shown walking to have various health benefits including:

  •  positive effects on fitness
  • fatness and resting blood pressure
  • blood pressure control
  • weight loss
  • depression
  • cardiovascular disease risk prevention


To assess the health benefits of outdoor walking groups.

Systematic review and meta-analysis of walking group interventions examining differences in commonly used physiological, psychological and well-being outcomes between baseline and intervention end.

Data sources
Seven electronic databases, clinical trial registers, grey literature and reference lists in English language up to November 2013.

Eligibility criteria
Adults, group walking outdoors with outcomes directly attributable to the walking intervention.

Forty-two studies were identified involving 1843 participants. There is evidence that walking groups have wide-ranging health benefits. Meta-analysis showed statistically significant reductions in mean difference for systolic blood pressure −3.72 mm Hg (−5.28 to −2.17) and diastolic blood pressure −3.14 mm Hg (−4.15 to −2.13); resting heart rate −2.88 bpm (−4.13 to −1.64); body fat −1.31% (−2.10 to −0.52), body mass index −0.71 kg/m2 (−1.19 to −0.23), total cholesterol −0.11 mmol/L (−0.22 to −0.01) and statistically significant mean increases in VO2max of 2.66 mL/kg/min (1.67 3.65), the SF-36 (physical functioning) score 6.02 (0.51 to 11.53) and a 6 min walk time of 79.6 m (53.37–105.84).

A standardised mean difference showed a reduction in depression scores with an effect size of −0.67 (−0.97 to −0.38). The evidence was less clear for other outcomes such as waist circumference fasting glucose, SF-36 (mental health) and serum lipids such as high density lipids.

There were no notable adverse side effects reported in any of the studies.

Walking groups are effective and safe with good adherence and wide-ranging health benefits. They could be a promising intervention as an adjunct to other healthcare or as a proactive health-promoting activity.

Open Access
Original Source BJSM

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Does active commuting improve psychological wellbeing?

Does active commuting improve psychological wellbeing?
Longitudinal evidence from eighteen waves of the British Household Panel Survey
Adam Martin, Yevgeniy Goryakin, Marc Suhrcke



The aim of this study is to explore the relationship between active travel and psychological wellbeing.

  • Impact of commuting behaviour on wellbeing was explored using individual fixed effects analyses.
  • Compared to driving, wellbeing was higher when using active travel or public transport.
  • Use of active travel reduced the likelihood of two specific GHQ12 psychological symptoms.
  • Switching from car driving to active travel improved wellbeing.
  • Wellbeing increased with travel time for walkers, but decreased for drivers.


The aim of this study is to explore the relationship between active travel and psychological wellbeing.


This study used data on 17,985 adult commuters in eighteen waves of the British Household Panel Survey (1991/2–2008/9). Fixed effects regression models were used to investigate how travel mode choice, commuting time and switching to active travel impacted on overall psychological wellbeing and how (iv.) travel mode choice impacted on specific psychological symptoms included in the General Health Questionnaire.


After accounting for changes in individual-level socioeconomic characteristics and potential confounding variables relating to work, residence and health, significant associations were observed between overall psychological wellbeing (on a 36-point Likert scale) and (i.) active travel (0.185, 95% CI: 0.048 to 0.321) and public transport (0.195, 95% CI: 0.035 to 0.355) when compared to car travel, (ii.) time spent (per 10 minute change) walking (0.083, 95% CI: 0.003 to 0.163) and driving (−0.033, 95% CI: −0.064 to −0.001), and (iii.) switching from car travel to active travel (0.479, 95% CI: 0.199 to 0.758). Active travel was also associated with reductions in the odds of experiencing two specific psychological symptoms when compared to car travel.


The positive psychological wellbeing effects identified in this study should be considered in cost–benefit assessments of interventions seeking to promote active travel

Full article click here (Open Access)

Original source Michael Evans

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Free Webinar – Building Bridges between Transportation and Health

Building Bridges between Transportation and Health

Meeting Description:
This webinar will discuss the connection between transportation and health and give insight into the specific process one community used to fund programs and how the programs are implemented from start to finish. It will also highlight how advocacy and community organizing are used to move projects forward.

To register click here

Wed, Jun 3, 2015

02:00 PM EDT

1 hour

American Public Health Association

Moderator:  Megan Wier, MPH
(Lead Staff, Health, Transportation and Equity at San Francisco Department of Public Health)

Leslie Meehan, AICP
(Director of Healthy Communities, Nashville Area Metropolitan Planning Organization)

Leslie will provide an overview of the process used to incorporate health into transportation planning, policy, funding, data collection and measurement in the greater Nashville region.  She will provide information on how the MPO evaluates and prioritizes projects by health and equity, and how health data is used to predict population-level changes in health outcomes from increased active travel.

Scott Bricker
(Executive Director, America Walks)
Scott will discuss advocacy and community organizing as tools to move projects forward. He will provide examples of communities that have improved walkability and active transportation through organized efforts.

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Research Associate post in transport and health at University College of London

Applicants are invited for a Research Associate position in an exciting cross-faculty research project: Street mobility and accessibility: developing tools for overcoming older people’s barriers to walking to develop tools to measure and model community severance. The main responsibility will be to analyse questionnaire data from the case studies, and assist with project management.

Community severance (CS) arises when transport infrastructure or the speed or volume of traffic prevent people from accessing goods, services or people. Effects include reduction in social networks and psychological barriers to use of streets for walking or social spaces. Health effects are assumed but have not been studied. More information about the project can be found at 

This is a full-time post however we will consider applicants who wish to work less than full time.

The post is funded until 31st December 2016 and is available from 1st July 2015 (or by negotiation) in the first instance.

Key Requirements

Applicants must have a PhD in a relevant area or equivalent research experience, experience in working in surveys and/or analysing survey data (including larger data sets), and an understanding of the process of carrying out academic research and surveys. Proven ability and commitment to carry out and complete high quality original research and publication of original research papers in peer reviewed journals are essential, as are excellent interpersonal, oral and communication skills. Project management experience is desirable.

The closing date is 28th April 2015 & interviews will probably be first week of May.

For more information: click here (Reference 1458689)

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An exciting new MSC in Transport, health and policy at University College London from Autumn 2015



The strong links between transport and health are becoming better understood and, in April 2013, they were given formal recognition through the transfer to English local authorities of responsibility for public health.  For the first time in decades, there is the opportunity for local policies relating to transport and public health to fit together.

This is a challenge: during the years of policy separation, practitioners in the two fields developed different languages and cultures.  England is not unique in this: transport and health have a habit of not talking to each other in many parts of the world.

This MSc is a practical response to this situation and has been developed by staff at UCL whose expertise in the areas of both transport and public health is recognised globally. Those undertaking the MSc in Transport, Health and Policy will be equipped with the skills to generate, design and implement policies that will exploit the positive links between the two areas.

The four core modules take the student from the identification of problems and opportunities, through the generation and appraisal of responses, to championing and delivering policies in the real world.  The course content and teaching methods take proper account of the need for “hard” and “soft” skills so, for example, students will learn both how to analyse large data sets and how to lead multi-disciplinary teams in policy delivery.  And the novel course structure uses distance learning extensively and so will suit busy people and those far from London.

During the course, students will learn the latest evidence on the role of sustainable transport and its promotion, on increasing safe mobility and on the transport impacts of health policies such as the location of facilities.  At all times the focus will be on harnessing the potential for transport and health policies to support one another and on preventing them from undermining each other.

To find out more, visit the course webpage.  For details of entry requirements, fees, application procedures and possible funding, visit the course page on the UCL Prospectus website.  If you have a question, contact Programme Director Dr Catherine Holloway (

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