title: Cycling in São Paulo, Brazil (1997-2012): Correlates, time trends and health consequences.
abstract: The purpose of the study was to describe cyclists and cycling trips, and to explore correlates, time trends and health consequences of cycling in São Paulo, Brazil from 1997 to 2012. Cross-sectional analysis using repeated São Paulo Household Travel Surveys (HTS). At all time periods cycling was a minority travel mode in São Paulo (1174 people with cycling trips out of 214,719 people). Poisson regressions for individual correlates were estimated using the entire 2012 HTS sample. Men were six times more likely to cycle than women. We found rates of bicycle use rising over time among the richest quartile but total cycling rates dropped from 1997 to 2012 due to decreasing rates among the poor. Harms from air pollution would negate benefits from physical activity through cycling only at 1997 air pollution levels and at very high cycling levels (≥ 9 h of cycling per day). Exposure-based road injury risk decreased between 2007 and 2012, from 0.76 to 0.56 cyclist deaths per 1000 person-hours travelled. Policies to reduce spatial segregation, measures to tackle air pollution, improvements in dedicated cycling infrastructure, and integrating the bicycle with the public transport system in neighborhoods of all income levels could make cycling safer and prevent more individuals from abandoning the cycling mode in São Paulo.
authors.affiliation: Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo (FSP-USP), São Paulo, Brazil.
authors.forename: Thiago Hérick
authors.initials: TH
authors.lastname: Sá
authors.affiliation: University of Illinois at Chicago, Chicago, USA.
authors.forename: Ana Clara
authors.initials: AC
authors.lastname: Duran
authors.affiliation: UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge.
authors.forename: Marko
authors.initials: M
authors.lastname: Tainio
authors.affiliation: Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo (FSP-USP), São Paulo, Brazil.
authors.forename: Carlos Augusto
authors.initials: CA
authors.lastname: Monteiro
authors.affiliation: UKCRC Centre for Diet and Activity Research (CEDAR), MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge.
authors.forename: James
authors.initials: J
authors.lastname: Woodcock
keywords: Brazil; Cycling; Health promotion; Healthy city; Motor activity; Risk assessment; Transportation; Urban health