Walking and cycling to health: a comparative analysis of city, state, and international data

Abstract

Objectives: We sought to determine the magnitude, direction, and statistical significance of the relationship between active travel and rates of physical activity, obesity, and diabetes.

Methods: We examined aggregate cross-sectional health and travel data for 14 countries, all 50 US states, and 47 of the 50 largest US cities through graphical, correlation, and bivariate regression analysis on the country, state, and city levels.

Results: At all 3 geographic levels, we found statistically significant negative relationships between active travel and self-reported obesity. At the state and city levels, we found statistically significant positive relationships between active travel and physical activity and statistically significant negative relationships between active travel and diabetes.

Conclusions: Together with many other studies, our analysis provides evidence of the population-level health benefits of active travel. Policies on transport, land-use, and urban development should be designed to encourage walking and cycling for daily travel.

Figures

FIGURE 1

Relationship between adult obesity and active transport in Australia and 13 countries in Europe and North America: 2000–2006. Note. BW = bicycle + walk. Source. Data from Bassett et al. *P < .01; **P < .001.

FIGURE 2

Relationship between share of workers commuting by bicycle or foot and share of adults with levels of physical activity recommended by the Centers for Disease Control and Prevention: 50 US states and 47 of the 50 largest US cities, 2007. Note. BW = bicycle + walk. Source. Data from the Centers for Disease Control and Prevention and the US Census Bureau. *P < .01; **P < .001.

FIGURE 3

Relationship between share of workers commuting by bicycle or foot and self-reported obesity levels: 50 US States and 47 of the 50 largest US cities, 2007. Note. BW = bicycle + walk. Source. Data from the Centers for Disease Control and Prevention and the US Census Bureau. *P < .01; **P < .001.

FIGURE 4

Relationship between share of workers commuting by bicycle or foot and share of population with diabetes: 50 US States and 47 of the 50 largest US cities, 2007. Note. BW = bicycle + walk. Source. Data from the Centers for Disease Control and Prevention and the US Census Bureau. *P < .01; **P < .001.