When Worlds Collide: Observations on the Integration of Epidemiology and Transportation Behavioral Analysis in the Study of Walking

Abstract

Since obesity has emerged as a public health crisis in the United States, the factors that influence physical activity are of interest to both epidemiologists and transportation researchers. This article describes different approaches taken by the two disciplines to this issue. "Utilitarian" walking to accomplish a task, as opposed to structured exercise, could be a highly sustainable way for people to achieve recommended levels of physical activity. Transportation planners have begun to investigate factors of urban form and transportation services that influence the choice to walk. Epidemiologists have become more aware of the importance of factors in the built and social environment that could influence health behaviors like walking. Few transportation studies focus on the generation of the utilitarian walk trip as the key variable; rather, they include it in more general discussions of urban form. Likewise, most epidemiologic studies have not focused on utilitarian walking, but have folded it into an overall measure of physical activity that emphasizes structured exercise. Further transportation research should examine the effects of improved mobility services in addition to alterations of the built environment. Integration of epidemiologic and transportation behavioral research could enhance our understanding of the role of urban and transportation factors on physical activity.

Walking behaviours from the 1965–2003 American Heritage Time Use Study (AHTUS)

“…The current growing focus on a broad range of walking behaviours as a source of healthful physical activity is the product of a number of related factors including: 1) the US. Surgeon General endorsed public health guidelines that promote daily activity that is of at least 30 minutes in duration and of at least moderate intensity (equivalent to brisk walking) [ 25 ]; 2) the proportion of American adults who achieve recommended levels of physical activity has continued to be low [ 26 ]; 3) high levels of attrition from structured exercise programs is a well-known phenomenon [ 27 ]; 4) research on the benefits of active living vs. prescriptive exercise expanded beliefs about dose-response relationships [ 28 ]; 5) the explosion of research related to the impact of the built environment on physical activity continues to fuel interest in transportation-related and lifestyle-related walking [ 29 ]; and, 6) the persisting popularity of objective monitoring using body worn instruments (including accelerometers and pedometers) has greatly advanced researchers', practitioners', and lay peoples' interest in and ability to quantify physical activity volumes [ 30 ]. Against this context, and in the face of few complete and consistent data sources, it is rational to pursue the feasibility of amalgamation of existing data sets in an attempt to establish foundational data and begin to examine cross-time patterns.…”

Environmental and psychosocial correlates of physical activity in Portuguese and Belgian adults

“…From a public health perspective, it is important to notice that regular walking may not (only) be the result of deliberate decision-making but may (also) be an automatic reaction to a supportive neighbourhood. As we know that walking is the most commonly reported physical activity behaviour in Europe 21 with more than half of the population reporting walking for 10 to 60 min on 4 to 7 days per week, and walking can be easily incorporated in daily life which is the ideal activity for sedentary, 'non-sportive' or very busy people, more attention should be paid to building and/or maintaining 'walking-friendly' environments 35 . Although the variance explained may not be overwhelming, environmental changes may affect large populations for a prolonged period of time which may result in population health benefits and reduced health costs.…”

The Role of Personal Values, Urban Form, and Auto Availability in the Analysis of Walking for Transportation

“…In this article, the term ''walking'' or ''walk trips'' refers to trips taken to a destination, such as the workplace, a restaurant, or a church for a purpose other than purely exercise or pleasure. 13 The former trips are referred to as ''walking for transportation'' in this article; the latter are referred to as ''walking for recreation'' and are not covered in this article.…”