Fourteen pathways between urban transportation and health: A conceptual model and literature review

Glazener, Andrew; Sanchez, Kristen A.; Ramani, Tara; Zietsman, Josias; Nieuwenhuijsen, Mark; Mindell, Jennifer S.; Fox, Mary A.; Khreis, Haneen

doi:10.1016/j.jth.2021.101070

Cited by 71 publications

(38 citation statements)

References 203 publications

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“…Transport impacts health in many ways [ 1 , 2 , 3 ]. Transport provides access to education, employment, healthcare, food and other amenities but car-dominated transport systems contribute to major global health challenges, including climate change, air pollution, obesity and road injury [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Transport on Population Health and Health Equity for Māori in Aotearoa New Zealand: A Prospective Burden of Disease Study

Randal

Shaw

McLeod

et al. 2022

IJERPH

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Background: The land transport system influences health via a range of pathways. This study aimed to quantify the amount and distribution of health loss caused by the current land transport system in Aotearoa New Zealand (NZ) through the pathways of road injury, air pollution and physical inactivity. Methods: We used an existing multi-state life table model to estimate the long-term health impacts (in health-adjusted life years (HALYs)) and changes in health system costs of removing road injury and transport related air pollution and increasing physical activity to recommended levels through active transport. Health equity implications were estimated using relative changes in HALYs and life expectancy for Māori and non-Māori. Results: If the NZ resident population alive in 2011 was exposed to no further air pollution from transport, had no road traffic injuries and achieved at least the recommended weekly amount of physical activity through walking and cycling from 2011 onwards, 1.28 (95% UI: 1.11–1.5) million HALYs would be gained and $7.7 (95% UI: 10.2 to 5.6) billion (2011 NZ Dollars) would be saved from the health system over the lifetime of this cohort. Māori would likely gain more healthy years per capita than non-Māori, which would translate to small but important reductions (2–3%) in the present gaps in life expectancy. Conclusion: The current transport system in NZ, like many other car-dominated transport systems, has substantial negative impacts on health, at a similar level to the effects of tobacco and obesity. Transport contributes to health inequity, as Māori bear greater shares of the negative health impacts. Creating a healthier transport system would bring substantial benefits for health, society and the economy.

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Section: Introductionmentioning

confidence: 99%

The Impact of Transport on Population Health and Health Equity for Māori in Aotearoa New Zealand: A Prospective Burden of Disease Study

Randal

Shaw

McLeod

et al. 2022

IJERPH

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“…Yet, how active living promotes the health of individuals is only partially known. Systematic reviews of the effects of the built environment on active ageing consistently point to the need for mechanistic studies to enable targeted interventions [ 4 , 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Neighborhood Makes or Breaks Active Ageing? Findings from Cross-Sectional Path Analysis

Gan

Cheng

et al. 2022

IJERPH

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Mental ill-health prolongs and complicates other chronic illnesses, which is a major public health concern because of the potential stress it places on health systems. Prevention via active aging and place-based interventions thus became increasingly important with population aging, e.g., through health promotion and age-friendly neighborhoods. However, how the targeted outcomes of these efforts are related remains unclear. This paper examined whether the relationship between active living and mental health or health-related quality of life is mediated by neighborhood cohesion. Cross-sectional data were drawn from n = 270 community-dwelling adults aged 50 and above in the Gerontology Research Program—Center for Ageing Research in the Environment (GRP-CARE) Survey. Path analysis showed that one can live actively for better mental health (Btotal = 0.24), but it is largely mediated by neighborhood cohesion (37%). Further examination of the factors of neighborhood cohesion showed that this mediation is explained by communal affordance (Bindirect = 0.05) and neighborhood friendship (Bindirect = 0.05). Additional study of the association between these mediators and factors of mental health revealed two psychosocial processes: (1) better community spaces (e.g., greenery and third places) support communal living (B = 0.36) and help older adults obtain emotional support (B = 0.32) for greater autonomy (B = 0.25); (2) spending more time outdoors enhances neighborhood friendship (B = 0.33) and interpersonal skills (B = 0.37), which in turn improves coping (B = 0.39). In short, the effects of active living on health are limited by one’s neighborhood environment. Neighborhood cohesion must be considered or it may stifle individual and policy efforts to age actively and healthily in urban environments. Context-sensitive implementations are required.

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“…We will develop a conceptual framework and frame the issues based on our previous work (Urban and Transport Planning Health Impact Assessment, UTOPHIA model) 26 27 34–36. The UTOPHIA tool, which is based on our previous work, will be further developed with algorithms that will be implemented in the statistical software R (figure 1).…”

Section: Methods and Analysesmentioning

confidence: 99%

Study protocol of the European Urban Burden of Disease Project: a health impact assessment study

et al. 2022

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IntroductionCities have long been known to be society’s predominant engine of innovation and wealth creation, yet they are also hotspots of pollution and disease partly due to current urban and transport practices. The aim of the European Urban Burden of Disease project is to evaluate the health burden and its determinants related to current and future potential urban and transport planning practices and related exposures in European cities and make this evidence available for policy and decision making for healthy and sustainable futures.Methods and analysisDrawing on an established comparative risk assessment methodology (ie, Urban and Transport Planning Health Impact Assessment) tool), in nearly 1000 European cities we will (1) quantify the health impacts of current urban and transport planning related exposures (eg, air pollution, noise, excess heat, lack of green space) (2) and evaluate the relationship between current levels of exposure, health impacts and city characteristics (eg, size, density, design, mobility) (3) rank and compare the cities based on exposure levels and the health impacts, (4) in a number of selected cities assess in-depth the linkages between urban and transport planning, environment, physical activity and health, and model the health impacts of alternative and realistic urban and transport planning scenarios, and, finally, (5) construct a healthy city index and set up an effective knowledge translation hub to generate impact in society and policy.Ethics and disseminationAll data to be used in the project are publicly available data and do not need ethics approval. We will request consent for personal data on opinions and views and create data agreements for those providing information on current and future urban and transport planning scenarios.For dissemination and to generate impact, we will create a knowledge translation hub with information tailored to various stakeholders.

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Fourteen pathways between urban transportation and health: A conceptual model and literature review

Cited by 71 publications

References 203 publications

The Impact of Transport on Population Health and Health Equity for Māori in Aotearoa New Zealand: A Prospective Burden of Disease Study

The Impact of Transport on Population Health and Health Equity for Māori in Aotearoa New Zealand: A Prospective Burden of Disease Study

Neighborhood Makes or Breaks Active Ageing? Findings from Cross-Sectional Path Analysis

Study protocol of the European Urban Burden of Disease Project: a health impact assessment study

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