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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
Tennessee Public Health Association_2012 2
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
20
25
30
USA
Austra
lia
Canad
a
Irelan
d
Franc
e
Denm
ark
Finlan
d
Germ
any
Sweden
Spain
Nethe
rland
s
Switzer
land
Ob
esi
ty P
reva
len
ce (
%)
0
10
20
30
40
50
60
70
Wal
k +
Bik
e +
Tra
nsit
Tri
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
Bassett, Pucher, et al., J Phys Act Health, 2010
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.
Bassett, Pucher, et al., J Phys Act Health, 2010
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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)