Journal of Transport & Health最新文献

Introduction

Although many studies have addressed accessibility inequity of healthcare services, little research has examined differences in accessibility and its spatiotemporal disparities across different travelling strategies at different times of a day. However, a static accessibility healthcare measure at one point in time may inadequately reflect the true equity of medical treatment over different time periods, often leading to over- or under-estimates and then possible bias in the results.

Methods

This study presents a spatial and temporal analysis of accessibility to high-level healthcare services accounting for driving, PT with- and without-metro strategies in Dalian, China, using the 3SFCA method. Then, several metrics such as the Gini index and Palma ratio are used to evaluate how accessibility inequity changes over time and varies across different transport modes. In addition, accessibility desert and spillover are proposed to capture extremely over- or under-served areas of healthcare services.

Results

The integration of metro can effectively help narrowing the accessibility gap between urban and suburban areas, regardless of time periods, while the accessibility inequity for driving during morning peak hours is the highest among all the nine examined scenarios. The accessibility disparities between the two travelling strategies within PT was statistically significant. Accessibility desert and spillover areas over time are also identified, which suggests the existence of different inequity patterns of extreme accessibility across spaces and time periods.

Conclusions

The variability of traffic conditions at different times of the day leads to variations in travel times, which in turn affects accessibility during different time periods across different transport modes. The results contribute to a better understanding of how spatial differences in healthcare accessibility are associated with the integration of travel strategies and temporal dynamics, and showing how to capture areas with extreme good/bad accessibility from an equity-focused time geography framework.

Introduction

Transportation use affects participation in daily activities, health and well-being. Persons with disabilities rely on paratransit services if they are not able to use public transport. The per-trip costs of paratransit services in Switzerland are high, and the responsibility for financing these trips (e.g., social insurance, canton) varies depending on the purpose of travel. We hypothesized that cost and financing factors of paratransit services increase dissatisfaction with participation in daily activities of persons with disabilities in Switzerland. The study's objective is to investigate which cost and financing factors affect dissatisfaction with participation in daily activities.

Methods

Using a cross-sectional study design, we conducted a self-administered online questionnaire. We included paratransit service users or relatives of paratransit service users aged 18 years or older. We analyzed the data using the multiple correspondence-, lasso- and regression analysis.

Results

A statistically significant effect on lower levels of dissatisfaction with participation in daily activities had high costs of paratransit services (Odds ratio (OR) = 3.45, 95% Confidence interval (CI) [1.41, 8.36]), not using paratransit services to leisure activities (OR = 2.39, 95% CI [1.28, 4.58]) and work (OR = 4.11, 95% CI [1.22, 20.89]), and getting trips financed to leisure activities by social insurances and benefits (OR = 3.06, 95% CI [1.08, 8.42]).

Conclusion

Concerning the influence of transportation on health and wellbeing, policy-makers and transportation planners may reflect on the effect of cost and financing factors of paratransit services on dissatisfaction with participation in daily activities of persons with disabilities. This is particularly important when the dissatisfaction stems from reduced use of paratransit services for leisure activities, due to high costs.

Introduction

We adapt and extend the Transmission of Virus in Carriages (TVC) model, a Quantitative Microbial Risk Assessment (QMRA) computational model originally developed to estimate exposure risk to SARS-CoV-2 in a subway carriage, to estimate exposure risk on a bus. The aim is to analyse the relative importance of different behavioural and environmental factors influencing exposure in this public transport setting, especially exposure to large doses when considering viral load variability between infectious passengers.

Methods

The QMRA model considers individual exposure during a bus journey through three routes: close-range exposure to aerosols and droplets due to being at close proximity ($<$2m) of an infected passenger, long-range airborne exposure at long distances ($>$2m), and transmission via contaminated surfaces (fomite route).

Results

Model predictions show that disease prevalence and bus loading levels have a major impact both on the likelihood of exposure and probability of receiving a large dose. Mask wearing is predicted to greatly reduce the magnitude of doses received, especially from close-range exposure. Assumptions around viral load also have a major impact on doses received, with large long-range airborne doses only occurring under very wide viral load distributions. Doses are not uniform around the bus, with close-range dose being generally more likely in the middle of the bus and fomite doses depending on the types of available surfaces around passengers’ seated/standing positions. Surface contamination is predicted to be greatest on traversal poles that may be touched by many passengers while boarding and alighting.

Conclusions

These model predictions have implications on the effectiveness of various mitigations to SARS-CoV-2 transmission on buses.

Background

Walking is a widespread and multifaceted activity among residents in high-density cities, making assessing the neighborhood walking environments important. Existing tools for assessing walkability in high-density cities primarily focus on the immediate environment of sidewalks. However, an individual's walking behavior is influenced by environmental characteristics across multiple dimensions and scales. Consequently, based on a systematic analysis of the features of high-density cities, this study proposes the High-density Environment Assessment Tool (HEAT). This hybrid approach comprehensively assesses walkability in high-density cities by incorporating variables of neighborhood, segment (sidewalk), and crossing.

Methods

The HEAT consisted of three sections with 108 items. To validate the reliability and applicability, field tests were conducted in two 15-min walkable neighborhoods with different built environment contexts in Chongqing City, China. The neighborhood section was objectively assessed using ArcGIS Software. The segment section and crossing section were audited through systematic on-site observation. Four pairs of trained raters assessed all of the segments (n = 139) and crossings (n = 123) within the two neighborhoods. The inter-rater reliability of the repeated audit data was evaluated by Kappa/Weighted Kappa or Percentage Agreement values. A web-based application was used for data collection and input.

Results

For the neighborhood section, 21 assessment items were included. For the segment and crossing sections, 87 assessment items were included for the reliability test, and 84 (96.6%) of the items indicated satisfying inter-rater reliability (with Kappa/Weighted Kappa value ≥ 0.4 or high Percentage Agreement). In addition, the audit of each segment and crossing sample was completed in an average of 7.9 and 1.8 min, respectively.

Conclusions

The results indicated that the HEAT was reliable and efficient. The HEAT provided an effective tool for assessing the walkability of the neighborhood built environment in high-density cities, thereby facilitating environmental interventions aimed at promoting walking activities.

Osteoporosis can lead to an increased risk of fragility fractures, which are closely associated with substantial loss of function, morbidity, and mortality, particularly in older adults. While walkable neighborhoods are recognized as crucial features contributing to health aging, research exploring its specific association with fragility fractures remains limited, especially in the countries with high rates of aging populations. In this study, we examined the relationship between fracture outcomes and neighborhood built environment using a five-year period of fracture history data from 39,577 older adults (≥75 years old). Multivariate logistic regression models were performed to estimate the odds ratios of fracture outcome for each built environment attribute. Our findings offer new insights into urban planning strategies aimed at mitigating the risk of fragility fractures. Recommended strategies include: 1) prioritizing the creation of livable city with diverse destinations and facilitating easy access to public transportation; 2) the provision of cultural facilities, catering establishments, grocery stores, and drug stores, especially cultural facilities; 3) avoid establishing residences in high slope terrain areas.

Introduction

The world is facing multiple challenges, e.g. in the realm of health, urbanization, climate change and social inclusion. Mobility can be part of the problem yet has the potential to be part of the solution. Serious games can support decision-making in a complex environment. This paper describes a serious game that aims to stimulate individual learning of (future) professionals in transport and urban planning, and facilitate discussions on goals and arguments concerning different (new) mobility options.

Methods

This paper presents the first version of the serious game: ‘the Optimal Mobility Mix’. This card game was developed and played in five sessions in the Netherlands, India and the USA with over 100 participants. Feedback was collected informally in a debrief, through a survey (N = 25) and through observation.

Results

During the game, participants formed small groups and collaborated to select a mobility mix using playing cards that aligned with the five societal goals (effective mobility, efficient city, economy, environment & health and equity), of the 5E framework (Van Oort et al., 2017). The survey indicated that the game was highly interactive, fun and relevant. Although the game's ‘reflection of reality’ scored relatively low, it still remained positive.

Conclusions

Overall, the game successfully facilitated discussion on societal goals and transportation modes and appears positive on its learning objectives. The effect of the game in policy and decision making practice will be tested in future research. Striking a balance between capturing the complexity of reality and creating an accessible and flexible model for professionals to interact with – in the form of a game, is an ongoing challenge. Future developments aim to involve key players and broader planning-related policies through a codesign process with game design iterations. To support this process, observations and recordings can be intensified to improve feedback processing.

Background

Children's independent mobility (CIM), i.e., the autonomous travel and outdoor play without adult supervision, is crucial for child development. The literature on CIM has focused more on its predictors than its outcomes, and few existing reviews have primarily explored its contribution to children's physical well-being. The aim of this review is to analyze studies on the relation between CIM, particularly in (sub)urban neighborhoods, and children's psychological well-being variables.

Methods

A literature search run in nine electronic databases resulted in the selection of a final sample of 23 studies, out of 358 initial relevant hits. Peer-reviewed articles addressing at least one child psychological outcome of CIM, referring to (sub)urban residential areas, and considering children and adolescents from school-age throughout adolescence, were analysed.

Results

The reviewed studies, published between 1999 and 2020, were mainly conducted in Europe and by quantitative design, and most of them focused on the consequences of CIM for children and adolescents up to 15 years old. Findings suggest a prevalence of studies exploring CIM's benefits for their socio-emotional (e.g., lower fear of crime, enhanced sociability) followed by cognitive (e.g., better spatial knowledge) development.

Conclusions

Empirical studies on psychosocial outcomes of CIM are lacking, possibly due to the decline of this activity among children and youth also related to generalised lockdown affecting those specially in (sub)urban neighbourhoods. Moreover, this review shows that psychological benefits of CIM for children have been under looked in the literature and highlights that children's cognitive abilities (ex. spatial cognition) and socio-emotional growth (ex. social interaction skills) may be enhanced through this activity, emphasising the need for more empirical research on this topic.

Introduction

Older individuals in China face a heightened risk of injuries on urban buses. While the Driving Behaviour Questionnaire (DBQ) effectively gauges drivers' behaviours and predicts injury involvement, the link between aberrant driving and older passenger injuries among urban bus drivers remains underexplored. This study refines the UB-DBQ for urban bus drivers, probing its association with older passenger injuries.

Methods

The Urban Bus Driving Behaviour Questionnaire (UB-DBQ) was adapted, incorporating unique aspects of urban bus driving. An online survey, based on this revised UB-DBQ, was administered to 710 Chinese urban bus drivers in August 2022. Using principal component factor analysis and oblique rotation-promax, a four-factor UB-DBQ emerged. Correlation and difference tests analysed the relationship between driving behaviours and older passenger injury incidents.

Results

The four-factor UB-DBQ offers a robust fit for Chinese urban bus drivers. Analysis revealed a prevalence of positive driving behaviours, offset by fewer aberrant actions, including aggression, errors, and violations. Notably, higher numbers of older passengers heightened aggressive and erroneous driving behaviours. A notable trend emerged: drivers largely attributed injuries to older passengers, a sentiment growing with more older passengers aboard. Crucially, driver self-assurance in safety and aggressive behaviour were key predictors of injuries involving older adult passengers.

Conclusions

The revised UB-DBQ serves as an effective tool for assessing urban bus driver behaviour and older passenger injury incidents in China. These insights emphasize the need for tailored driver training and risk strategies in line with the unique demands of urban bus driving in China. The UB-DBQ holds potential for shaping more precise and effective transport safety policies.

Introduction

This study investigates the effects of different types of social networks within different activities on an individual’s social and mental health in developing countries since the effects of involving other people or social networks on health have been studied particularly in developing countries.

Methods

The data was collected through a survey conducted from August to October 2019. The survey involved 420 individuals from 92 households, covering inputs on their socio-demographics, travel characteristics, time use, and activity diaries and the involvement of various social network types during the activities, travels performed, and Health Quality of Life. Multilevel modelling with a random slope is applied. For time-use and activity-travel participation information, respondents were asked to record their activities and travel within 15-min intervals for 5 consecutive weekdays with 25 activity classifications grouped as mandatory, leisure, and maintenance activities including online activities that could be conducted in or outside the home. It is also recorded whether other people are involved in each time slice of each activity. Companionship within different activities is then disaggregated into different types of social networks, namely other household members, relatives, close friends, and online friends.

Result

Engaging with other people is not necessary to gain positive results on social and mental health. Within different types of activities and different contexts, such as in developing countries that have higher percentages of low-income households, much time spent in engagements with other household members can worsen social and mental health.

Conclusion

In developing country contexts, better social health might be indicated by having more engagements with other people beyond household members and spending more time on travelling or out-of-home activities. However, more disposable income, more time for socialising and leisure activities, and more engagements with close and online friends all seem to be able to gain positive mental health conditions.

The current study reports how the adoption of emerging travel modes might change the prevalence of active travel (i.e., walking and biking) in the future. Results from a national survey in Norway indicate that, overall, increased use of emerging modes such as electric vehicles (EVs), autonomous vehicles (AVs), mobility services, and e-scooters does not significantly relate to the share of active travel. Neither ridesharing nor the use of AVs or e-scooters show any significant association with either a decrease or increase in active travel. Nevertheless, the role of e-bikes (shared/private) is noteworthy, as they are statistically less likely to replace traditional active travel modes. However, e-bikes do not show a positive correlation with increased rates of walking and biking (shared/private). Individuals who anticipate maintaining the same level of EV and carsharing use in the future as they do presently are less likely to reduce their walking frequency. In summary, while the promotion of emerging mobility modes may not pose a substantial threat to active travel, they do not appear to present a significant opportunity for increasing active travel participation.