encouraging physical activity and transportation...encouraging physical activity and health through...

09/14/2012

Tennessee Public Health Association_2012 1

Encouraging Physical Activity and Health Through Active Transportation

David R. Bassett, Jr.The University of Tennessee

Knoxville, TN

09/14/2012


Definitions

• Active Transportation‐ Use of walking, bicycling, and other non‐motorized transportation modes (that require energy expenditure) to get around.

• Utilitarian physical activity‐ physical activity acquired by commuting, errands, and other activities of daily life. It is distinct from leisure time physical activity (LTPA).

Definitions

• Built environment‐ the physical form and character of communities; comprised of 3 elements‐ transportation systems, land use patterns, and urban design

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Brief Outline

• Trends in Active Transportation (AT)

• Determinants of AT

• AT and Health

– International differences in AT

– State‐level comparisons within U.S.

1. TRENDS IN ACTIVE TRANSPORTATION

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Trends in Active Transportation in US

Pucher and Renne, 2003

U.S. School Travel

McDonald, AJPM 2007

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Trends in Where Americans Live

Transportation Research Board and IOM, 2005

However…

• Some European countries like Germany, Denmark, and the Netherlands, have made a conscious effort since the 1970s to promote active transportation

• In these cities, this has stabilized the percent of trips taken by cycling and walking at roughly 40% of total trips

Pucher and Buehler, Walking and Cycling for Healthy Cities, Built Environment, 2010

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2. DETERMINANTS OF ACTIVE TRANSPORTATION

Conceptual Model

L.D. Frank, P.O. Engelke, T.L. Schmid, 2003

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Built Environment

• Land Use‐ Population Density

• Land Use‐Mix/Diversity

• Accessibility

• Street Design

• Ped/Bike Infrastructure

Land Use‐ Housing Density

High Density (Urban) Low Density (Suburbs)

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Land Use‐Mix/Diversity

Fine Grain Coarse Grain

LD Frank, PO Engelke, and TL Schmid, 2003

Accessibility

High Walkability Low Walkability

Main Street, Ann Arbor, MI Rural Knox County, TN

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Accessibility

Good“Bikeability”

Upper image shows design elements of car‐friendly street, lower image shows street designed for multiple users. LD Frank, PO Engelke, and TL Schmid, 2003

Street Design

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Street Design

“Complete Street” designed for multiple users

Street designed exclusively for convenience of motorists

Designed according to AASHTO “Green book”,US DOT and FHWA

Pedestrian & Bike Infrastructure

Pedestrian Bridge, Des Moines No provision for pedestrians

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Does the Built Environment Influence Physical Activity?

Why are U.S. Cities Constructed the Way They Are?

• Urban planning in the 1930s & 1940s was done with a conscious effort to get people out of crowded cities, to reduce communicable diseases

• Ironically, the major public health problems of today are linked to chronic diseases, and our sprawling, car‐dependent environments contribute to the problem

Frank et al., Health and Community Design, 2003

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Mediating Variables(Impact Relationship Between Built Environment and PA)

• Personal Safety

• Traffic Safety

• Time

• Socio‐Economic Factors

• Climate

3. ACTIVE TRANSPORTATION AND HEALTH

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2008 Physical Activity Guidelines

• 150+ minutes per week of moderate‐intensity physical activity, or 75+ minutes per week of vigorous

• Structured exercise, or utilitarian physical activity

• Strength training 2 days per week

Active Transportation

Walking (3 mph) = 245 Calories/hour

Bicycling to work (10‐12 mph)= 475 Calories/hour

Ainsworth et al. Compendium of Physical Activities, 2011

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Public Transit Users

• 3312 Transit users on the 2001 NHTS

• Transit users spend a median of 19 min/day walking to and from transit

• 29% achieve 30+ min of walking/day, solely from transit

Bessler and Dannenberg, AJPM 2005

Regular PA and Obesity Prevention

• Regular physical activity reduces weight gain, based on longitudinal studies

• Over decades, these small reductions in excess weight gain accumulate into net savings that are quite significant

DiPietro L., Med Sci Sports Exerc. 1999

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Advantage of Active Commuting

• The “P” factor‐William Morgan, UW‐Madison

• It is purposeful

• Because active commuting accomplishes a purpose other than just exercise, this may increase long‐term adherence to PA

4. INTERNATIONAL DIFFERENCES IN ACTIVE TRANSPORTATION

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Swiss Transit

Copenhagen, Denmark

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Cycling in Amsterdam

John Pucher, Picasa web, Summer 2008

Running errands

John Pucher, Picasa Web, Summer 2008

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Amsterdam, Netherlands

John Pucher, Picasa Web, Summer 2008

Dedicated cycleway, Amsterdam

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Transportation in North America

Strip Malls

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John PucherProfessor, Rutgers University Urban Planning and Policy Development Program and Research Associate

B.A., University of North Carolina at Chapel Hill, 1972;

Ph.D., Massachusetts Institute of Technology, 1978

Active Transportation in 17 countriesBassett, Pucher, et al., J Phys Act Health, 2010

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Active Transportation & Obesity RatesBassett, Pucher, et al. J Phys Act Health, 2010

0

5

10

15

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25

30

USA

Austra

lia

Canad

a

Irelan

d

Franc

e

Denm

ark

Finlan

d

Germ

any

Sweden

Spain

Nethe

rland

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Switzer

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Ob

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ty P

reva

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ce (

%)

0

10

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Wal

k +

Bik

e +

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nsit

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ps (

%)

Obesity Prevalence Based on Self-Report (%) Walk + Bike + Transit Trips (% of Total)

Kilometers Cycled and Walked

Bassett, Pucher, et al., J Phys Act Health, 2010

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Calories burned


Conclusions

• Walking and biking are much more common in Europe than in the United States, Canada, and Australia.

• There is an inverse association between active transportation and obesity rates in these countries.


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5. REGIONAL DIFFERENCES IN ACTIVE TRANSPORTATION IN THE U.S.

Obesity Diabetes

Physical InactivityHeart Disease

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Physical Inactivity and Obesity

Physical Inactivity vs. Diabetes(BRFSS data, 2007)

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Active Commuting vs. Diabetes(ACS and BRFSS data, 2007‐09)

COMNUT

AKND

WI MTSDIA OR VTWYNE WANHRICTKS MACA HIMENM IDMO NVVA

NYAZMDINDEFL PAILMI

NCAR NJOHSC

KYGALA

OKAL TX

WVMS

TN

y = ‐2.698ln(x) + 11.371R² = 0.5537

4

5

6

7

8

9

10

11

12

13

1 2 3 4 5 6 7 8 9 10

Percent of Adults with Diabetes

Percentage of Trips to Work by Bicycle or on Foot

Regional differences in the built environment within the US

• SE states are more sprawling, and thus are more car‐dependent

• SE states are less walkable

• SE states have higher pedestrian and bicycle fatalities

• SE states have fewer miles of bike lanes and shared use paths

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Nashville Area Regional Transportation Plan 2035

• The Nashville MPO has committed to providing increased opportunities for physical activity, and dedicated funding for pedestrian and bicycle facilities

• A multi‐modal transportation system that includes adequate transit, sidewalks, bicycle paths, and greenways

• A paradigm shift in transportation policy

Skipper and Meehan, 2012

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How did they do it?

• Scenario planning showing that future population growth would result in severe traffic congestion if status quo is maintained

• Public opinion polls showed support for transportation alternatives

• Noted other benefits to AT such as health, traffic safety, and air quality

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Early results

• Out of 400 roadway projects ($6 billion), 75% of submitted roadway projects now include sidewalks, bike lanes, and/or greenways

Before

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After

“Smart Growth”

Good Community Design

Active Living(walking, bicycling, etc.)

Healthier Communities (less obesity, diabetes, CHD, and cancer)

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