Contrasts in active transport behaviour across four countries: how do they translate into public health benefits?
OBJECTIVE
Countries and regions vary substantially in transport related physical activity that people gain from walking and cycling and in how this varies by age and gender. This study aims to quantify the population health impacts of differences between four settings.


METHODS
The Integrated Transport and Health Model (ITHIM) was used to estimate health impacts from changes to physical activity that would arise if adults in urban areas in England and Wales adopted travel patterns of Switzerland, the Netherlands, and California. The model was parameterised with data from travel surveys from each setting and estimated using Monte Carlo simulation. Two types of scenarios were created, one in which the total travel time budget was assumed to be fixed and one where total travel times varied.


RESULTS
Substantial population health benefits would accrue if people in England and Wales gained as much transport related physical activity as people in Switzerland or the Netherlands, whilst smaller but still considerable harms would occur if active travel fell to the level seen in California. The benefits from achieving the travel patterns of the high cycling Netherlands or high walking Switzerland were similar.


CONCLUSIONS
Differences between high income countries in how people travel have important implications for population health.
Physical Activity and Health Unit, Institute of Epidemiology, Biostatistics and Prevention, University of Zurich, Zurich, Switzerland.
Thomas
T
Götschi
UKCRC Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK; Systems Research Institute, Polish Academy of Sciences, Warsaw, Poland.
Marko
M
Tainio
Berkeley, CA, USA.
Neil
N
Maizlish
School of Geography and the Environment, University of Oxford, Oxford, UK.
Tim
T
Schwanen
Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Anna
A
Goodman
UKCRC Centre for Diet and Activity Research, MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, UK. Electronic address: jw745@medschl.cam.ac.uk.
James
J
Woodcock
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001336:Automobiles / Q000706:statistics & numerical data; D001642:Bicycling / Q000502:physiology / Q000706:statistics & numerical data; D002140:California; D003431:Cross-Cultural Comparison; D004739:England; D005260:Female; D062489:Health Impact Assessment / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009426:Netherlands; D011795:Surveys and Questionnaires; D013557:Switzerland; D014186:Transportation / Q000379:methods* / Q000706:statistics & numerical data; D014504:Urban Health / Q000706:statistics & numerical data; D014852:Wales; D016138:Walking / Q000502:physiology / Q000706:statistics & numerical data; D055815:Young Adult
Active travel; Bicycling; Health impact assessment; Physical activity; Walking