Strongest benefits seen for cyclists

Commuters who cycle or walk to and from work or study may be at lower risk of mental and physical ill-health than those who do not rely on these options, according to a large long-term study published in the open access journal BMJ Public Health.

Although health benefits were observed for both forms of active commuting, the strongest health benefits were observed for cyclists among whom the risk of death from any cause was 47% lower, the findings showed.

Active travel is considered one of the most practical and sustainable ways to increase daily physical activity, and there is growing evidence in favor of its associated health benefits, the researchers note.

But the existing body of evidence is hampered by short monitoring periods, limited age groups and limited health outcomes, they add.

In an attempt to address these shortcomings, the researchers used nationally representative data from the Scottish Longitudinal Study (SLS), which is based on 5% of the Scottish population, derived from the 1991, 2001 and 2011 census results.

The researchers in 2001 focused on 16-74 year olds who traveled to Britain to work or study. After exclusions for incomplete data, the final analysis was based on 82,297 people.

Census respondents were asked to select which mode of transportation they used for the longest portion of their usual commute, based on distance. Active travel was defined as walking or cycling. All other commuting methods were defined as “inactive.”

The responses were linked to national hospital admissions for all causes, cardiovascular disease, cancer and road traffic accidents; deaths from all of these; and prescriptions for mental health conditions (tranquilizers, anti-anxiety medications, and antidepressants) from 2001 through 2018.

Several potentially influential factors were taken into account. These include age, gender, pre-existing health conditions, as well as socio-economic factors and distance to work/study.

Between 2001 and 2018, 4,276 participants died (more than 5% of the research group), almost half of whom died of cancer (2023; 2.5%). About 52,804 (just over 64%) were hospitalized, 9,663 (12%) of them because of cardiovascular disease, 5,939 (just over 7%) because of cancer and 2,668 (just over 3%) after a traffic accident .

A total of 31,666 study participants (38.5%) were prescribed a drug related to cardiovascular disease between 2009 and 2018, and 33,771 (41%) were prescribed a drug for poor mental health during the same period.

Compared to inactive commuters, those who walked to work/study were more likely to be female, younger, work shifts, travel shorter distances and live in a city. They were also less likely to have dependent children and tended to have lower household income and education levels.

Similarly, cyclist commuters were more likely to be male, younger, shift workers and urban residents, and less likely to be homeowners or caregivers.

After taking into account potentially influential factors, active commuting was associated with lower risks of death and mental and physical health problems compared to ‘inactive’ commuting.

Specifically, commuting by bicycle was associated with a 47% lower risk of death, a 10% lower risk of hospitalization and a 24% lower risk of hospitalization for cardiovascular disease.

It was also associated with a 30% lower risk of being prescribed a drug to treat cardiovascular disease, a 51% lower risk of dying from cancer and a 24% lower risk of being hospitalized due to the disease to be included. % lower risk of being prescribed medication for mental health problems.

But cyclists were twice as likely to be hospitalized as ‘inactive’ commuters after a road accident.

Commuting as a pedestrian was associated with an 11% lower risk of hospitalization for any cause, and a 10% lower risk of hospitalization for cardiovascular disease. It was also associated with 10% and 7% lower risks of being prescribed medications to treat cardiovascular disease and mental health problems, respectively.

This is an observational study and as such no firm conclusions can be drawn about causal factors. And the researchers acknowledge several limitations of their study. For example, the census responses reflect only one point in time and do not include overall physical activity levels. And prescription data was only available from 2009 onwards.

The census data also does not include multimodal trips, resulting in a potential overlap between active and ‘inactive’ commuters, they point out.

But they nevertheless conclude: “This study strengthens the evidence that active commuting has population-level health benefits and can contribute to a reduction in morbidity and mortality. That bicyclist and pedestrian commuting is associated with lower risks of prescription drug abuse for poor mental health is important evidence.” find.

“These findings provide direct evidence of the health benefits of active commuting in a Scottish context, and support current policy. This study has wider global relevance for efforts to reduce carbon emissions and switch to more active and sustainable modes of travel.”

But they warn: “Our finding that cyclists have twice the risk of becoming a road casualty compared to inactive commuters reinforces the need for safer cycling infrastructure.”