Introduction
Public transport use is common and often involves short walks to and from public transport stops. Population impacts of physical activity accumulated as part of public transport journeys are potentially substantial but remain understudied compared with other transport modes. This thesis aims to examine the potential health effects of public transport use.
Methods
(1) A systematic review of the cardio-metabolic health effects of public transport. (2) Analyses of nationally representative data to examine predictors of public transport use and related physical activity. (3) Examine the association between the English free older person’s bus pass and bus use and active travel levels, and establish whether these impacts differ across ethnic groups. (4) Analyses of census data to identify associations of public transport commuting with cancer and mortality.
Results
The systematic review found 10 studies and concluded that public transport was associated with reduced adiposity, with little research available on other outcomes. Public transport use in England is higher among: women, those of minority ethnicity and the socio-economically disadvantaged. Public transport users in England accumulated an average of 21 minutes a day of physical activity in the course of public transport journeys. The free bus pass had high uptake and was associated with higher bus use and active travel and these effects may be greater among ethnic minority groups. Public transport commuting in England and Wales was associated with reduced cancer incidence, with larger associations seen in rail commuters than bus commuters.
Discussion
Public transport use in England is common and is associated with reduced adiposity, higher physical activity and lower incidence of cancer. These findings suggest that increasing public transport use can improve population health through increased physical activity.