A shift from motorised travel to active transport: What are the potential health gains for an Australian city?

Change log
Zapata-Diomedi, Belen  ORCID logo  https://orcid.org/0000-0002-9238-0375
Knibbs, Luke D 
Ware, Robert S 
Heesch, Kristiann C 
Tainio, Marko 

INTRODUCTION: An alarmingly high proportion of the Australian adult population does not meet national physical activity guidelines (57%). This is concerning because physical inactivity is a risk factor for several chronic diseases. In recent years, an increasing emphasis has been placed on the potential for transport and urban planning to contribute to increased physical activity via greater uptake of active transport (walking, cycling and public transport). In this study, we aimed to estimate the potential health gains and savings in health care costs of an Australian city achieving its stated travel targets for the use of active transport. METHODS: Additional active transport time was estimated for the hypothetical scenario of Brisbane (1.1 million population 2013) in Australia achieving specified travel targets. A multi-state life table model was used to estimate the number of health-adjusted life years, life-years, changes in the burden of diseases and injuries, and the health care costs associated with changes in physical activity, fine particle (<2.5 μm; PM2.5) exposure, and road trauma attributable to a shift from motorised travel to active transport. Sensitivity analyses were conducted to test alternative modelling assumptions. RESULTS: Over the life course of the Brisbane adult population in 2013 (860,000 persons), 33,000 health-adjusted life years could be gained if the travel targets were achieved by 2026. This was mainly due to lower risks of physical inactivity-related diseases, with life course reductions in prevalence and mortality risk in the range of 1.5%-6.0%. Prevalence and mortality of respiratory diseases increased slightly (≥0.27%) due to increased exposure of larger numbers of cyclists and pedestrians to fine particles. The burden of road trauma increased by 30% for mortality and 7% for years lived with disability. We calculated substantial net savings ($AU183 million, 2013 values) in health care costs. CONCLUSION: In cities, such as Brisbane, where over 80% of trips are made by private cars, shifts towards walking, cycling and public transport would cause substantial net health benefits and savings in health care costs. However, for such shifts to occur, investments are needed to ensure safe and convenient travel.

Adult, Australia, Bicycling, Cities, Exercise, Female, Health Care Costs, Humans, Male, Markov Chains, Motor Vehicles, Particulate Matter, Prevalence, Public Health, Risk Factors, Transportation, Travel, Walking
Journal Title
PLoS One
Conference Name
Journal ISSN
Volume Title
Public Library of Science (PLoS)
Wellcome Trust (087636/Z/08/Z)
Economic and Social Research Council (ES/G007462/1)
Medical Research Council (MR/K023187/1)
Belen Zapata-Diomedi is supported by an Australian Postgraduate Award. BZD and JLV are part of the NHMRC CRE in Healthy, Liveable Communities (APP1061404). LDK acknowledges an NHMRC Early Career (Australian Public Health) Fellowship (APP1036620). MT and JW undertook the work at the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence. MT and JW gratefully acknowledged funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration.