Too far to walk or bike?

Larouche, Richard ; Barnes, Joel ; Tremblay, Mark S. 等

The latest Active Healthy Kids Canada Report Card on Physical Activity for Children and Youth indicates that only 25 to 35% of Canadian children and youth regularly engage in active transportation (AT; e.g., using non-motorized travel modes such as walking and cycling) to/from school, and these levels are approximately half of what they were a generation ago. (1) Moreover, only 5% meet the Canadian physical activity (PA) guidelines which recommend a minimum of 60 minutes of daily moderate- to vigorous-intensity PA. (1) Nevertheless, there is a growing body of evidence showing that AT to/from school is associated with greater daily PA levels among children and youth, and that cycling to/from school is associated with increased cardiovascular fitness. (2) In contrast, motorized travel is a form of sedentary behaviour that produces exhaust gases emissions that reduce air quality, exacerbate health conditions and contribute to climate change. (3)

In addition to attenuated AT levels, large decreases in children's independent mobility--that is their freedom to travel without adult supervision--have been noted internationally. (4,5) For instance, Hillman and colleagues (5) reported that in 1971, 80% of British 7-8 years olds were allowed to go to school without adult supervision, but this proportion decreased to only 9% by 1990. Children's autonomy for traveling to other neighbourhood destinations has also declined over time. (4) However, most of the literature on AT in children and youth has focused on the trip to/from school. (6,7)

In this regard, recent literature reviews have shown that distance between home and school (whether perceived by parents and children or objectively measured) is the greatest barrier to AT to/from school. (6,7) For example, in the United States, the proportion of children who walked or biked to/from school decreased from 41% to 13% between 1969 and 2001, and distance explained about 47% of this decline. (8) Nevertheless, among American children and youth living within 1.6 km from school, a reasonable walking or cycling distance, AT to/from school declined from 86% to 50% during the same time period, suggesting that other factors lead to motorized trips (i.e., heavy traffic, dangerous crossings, parental concerns about "stranger danger", etc.). (8)

Notwithstanding the importance of distance as a correlate of travel mode decisions, we believe that it should not be viewed as an insurmountable barrier or an obstacle that makes it truly impossible to engage in some AT. Below we describe several strategies to overcome this barrier based on social ecological theory. (9)

Although it is generally assumed that school travel mode choices are made by parents, at least for young children, (7) recent findings show that youth who have some input into the decision-making process are more likely to engage in AT to/from school. (10) This suggests that interventions targeting youth may be effective in increasing AT. Of particular interest, even if the school is impractically far to walk or bike, other destinations may be located closer to home such as parks, shops, friends' and family members' residence, and sport fields. AT to non-school destinations may represent a substantial source of PA. (11) In addition, by demonstrating competence in walking or biking safely for shorter trips, children could incrementally develop their independent mobility and distances previously determined to be excessive for AT may eventually become acceptable.

At the interpersonal level, parents who drive their children to school could drop them within a "walkable" distance so that they can walk for the remainder of the trip (accompanied or not). If parents' schedules make it inconvenient to do this on a regular basis, they could partner with other parents. Modeling from family and peers may also facilitate AT, (6) suggesting that if children and youth see significant others walking or cycling despite what they perceive as a long distance, they may be more likely to do so as well. Furthermore, parents' choices regarding the neighbourhood they live in and the school their children attend can directly influence the distance between home and school. Hence, if parents register their child in a neighbourhood school (if possible), the distance will likely be shorter, rendering AT more feasible.

At the community level, schools could develop partnerships with other nearby institutions that would allow parents to park their car on site temporarily while they walk their child the remaining distance to school. Such a partnership was successfully developed between a school and a church as part of a Safe Routes to School intervention in Atlanta, Georgia. (12) Similar partnerships could be established to allow school buses to park close to, but not at, school. From that point, walking school buses could be organized as a strategy to alleviate parental road safety concerns (i.e., heavy traffic, dangerous street crossings, etc.), which are a common barrier to AT. (7) An added benefit of this type of approach could be a reduction in motorized traffic in the vicinity of the school and related exhaust gases emissions. Such an approach may actually improve the safety for children engaging in AT.

A supportive built environment may also facilitate AT, but research indicates that urban form correlates of AT differ between children and adults. (6) For example, while greater population density and street connectivity may be associated with shorter routes to/from school and other destinations, these attributes may coincide with greater motorized traffic and associated road safety concerns. Hence, literature reviews have indicated inconsistent associations of density and connectivity with AT to/from school. (6,7) However, a recent study has found that well-connected networks of sidewalks along low traffic streets can favour AT to/from school. (13) Similarly, quiet neighbourhoods with street trees and interesting landscape might also render walking and cycling more appealing despite long distances.

From a broader policy perspective, decisions regarding school locations can have a major impact on the proportion of children and youth living close to their school. However, school location guidelines have recommended the construction of large schools which tend to have large catchment areas and are often built on the outskirts of cities where land is cheaper. (14) As a result, fewer children live within a "walkable" distance. Counter to this approach, the recent Canadian child- and youth-friendly land-use and transport planning guidelines recommend that urban planners and school administrators consider children's travel to a greater extent. (15) These guidelines specifically state that school policies and practices should favour children's AT and minimize car use that deprives children of an opportunity to exercise, gain independence, and experience their neighbourhood. Furthermore, urban planning policies may have a direct influence on distance between home and school. Such policies could require that new neighbourhoods offer a wide variety of amenities where children and youth could actively travel, including schools, parks and sport fields. In existing neighbourhoods, walking and cycling infrastructure can be improved and traffic calming measures can be implemented as a strategy to make AT safer and more enjoyable, even for long trips. Moreover, a recent report from Cancer Care Ontario recommended that municipality-wide changes be implemented to make it easier and safer to walk, cycle and use public transport. This may translate into the adoption of a Complete Streets policy whereby transportation planners and engineers design the entire street network for all road users, and not only for car drivers. While such policies do not directly address distance between destinations, they can make active transportation more "palatable" despite the distance.

In conclusion, while there is consistent evidence showing that distance between home and school is a strong determinant of AT, there are nonetheless many ways by which children and youth can engage in at least some active trips. We have identified several strategies within five different levels of influence based on the social ecological theory. Furthermore, a key feature of ecological models is the interactions between different levels of influence. (9) For example, a favourable environment could influence parental attitudes about children's capacity to walk or bike safely, which would in turn lead to travel behaviour change. Further research is warranted to examine such interactions and to investigate the correlates of AT for non-school purposes. Additionally, social marketing campaigns could be developed to raise awareness about strategies to incorporate AT into one's lifestyle, and perhaps to encourage parents to reconsider what constitutes a "walkable" distance.

Conflict of Interest: None to declare.

La traduction du resume se trouve a la fin de l'article.

Can J Public Health 2013; 104(7): e487-e489.

REFERENCES

(1.) Active Healthy Kids Canada. Are we driving our kids to unhealthy habits? 2013 Active Healthy Kids Canada Report Card on Physical Activity in Children and Youth. Toronto, ON: Active Healthy Kids Canada, 2013.

(2.) Larouche R, Saunders T, Faulkner GEJ, Colley RC, Tremblay MS. Associations between active school transport and physical activity, body composition and cardiovascular fitness: A systematic review of 68 studies. J Phys Act Health 2012 Dec 17. [Epub ahead of print]

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(4.) Fyhri A, Hjorthol R, Mackett RL, Fotel TN, Kytta M. Children's active travel and independent mobility in four countries: Development, social contributing trends and measures. Transport Policy 2011;18:703-10.

(5.) Hillman M, Adams J, Whitelegg J. One False Move: A Study of Children's Independent Mobility. London: PSI Publishing, 1990.

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(9.) Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJF, Martin BW. Correlates of physical activity: Why are some people physically active and others not? Lancet 2012;380(9838):258-71.

(10.) Wong BYM, Faulkner G, Buliung R, Irving H. Mode shifting in school travel mode: Examining the prevalence and correlates of active school transport in Ontario, Canada. BMC Public Health 2011;11(618).

(11.) Smith L, Sahlqvist S, Ogilvie D, Jones A, Griffin SJ, van Sluijs E. Is active travel to non-school destinations associated with physical activity in primary school children? Prev Med 2012;54:224-28.

(12.) Henderson S, Tanner R, Klanderman N, Mattera A, Webb LM, Steward J. Safe Routes to School: A public health practice success story--Atlanta, 2008-2010. J Phys Act Health 2013;10:141-42.

(13.) Giles-Corti B, Wood G, Pikora T, Learnihan V, Bulsara M, Van Niel K, et al. School site and the potential to walk to school: The impact of street connectivity and traffic exposure in school neighborhoods. Health Place 2011;17(2):545-50.

(14.) Environmental Protection Agency. Travel and Environmental Implications of School Siting. Washington, DC: Environmental Protection Agency, 2003. Available at: http://www.epa.gov/dced/pdf/school_travel.pdf (Accessed June 17, 2013).

(15.) Gilbert R, O'Brien C. Canadian child- and youth-friendly land-use and transport planning guidelines. Winnipeg, MB: Centre for Sustainable Transportation, 2010. Available at: http://www.kidsonthemove.ca/uploads/ Canadian%20Guidelines,%202.pdf (Accessed June 17, 2013).

Received: July 2, 2013

Accepted: October 2, 2013

Richard Larouche, PhD, [1,2] Joel Barnes, MSc, [2] Mark S. Tremblay, PhD [1-3]

Author Affiliations

[1.] Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON

[2.] School of Human Kinetics, University of Ottawa, Ottawa, ON

[3.] Department of Pediatrics, University of Ottawa, Ottawa, ON

Correspondence: Richard Larouche, Postdoctoral fellow, Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Room R242, Ottawa, ON K1H 8L1, Tel: 613-737-7600, ext. 4191, Fax: 613-738-4800, E-mail: [email protected]