Active Transport and Health Outcomes: Findings from a Population Study in Jiangsu, China

To investigate the prevalence of active transport (AT, defined as walking or bicycling for transport) and to explore the association between AT and health outcomes, we conducted a population-based cross-sectional study in Jiangsu, China, where walking and bicycling are still the main modes of transport. In this study, 8400 community residents aged 18 or above were interviewed following a multistage random sampling method (100% response rate). Face-to-face questionnaire survey data, anthropometric measurements, and biochemical data from blood tests were collected. Results show that 49.6% of the subjects, as part of daily transport, actively traveled on average 5.3 days per week, 53.5 minutes per day, and 300.3 minutes per week. There was an inverse correlation between AT and some health outcomes: AT respondents had a higher prevalence of cholesterol disorder; AT respondents who actively travelled every day had a higher risk of diabetes, whilst AT respondents with shorter daily or weekly duration had a lower risk of obesity, central obesity, and cholesterol disorder. Moreover, AT influences more health aspects among urban residents than among rural residents. Findings of this study do not support the notion that AT is beneficial to population health. Further research is needed in determining the negative side effects of AT. 1. Introduction As the result of rapid economic development in recent years, many countries are experiencing a fast-growing automobile population and steadily improving public transportation infrastructure, which accelerate the transition from active to passive transport. Active transport (AT), which usually means walking, cycling, and using public transport, could have multiple health benefits by increasing physical activity, protecting people from some chronic diseases and reducing the adverse health effects of motor vehicle transport [1–3]. Many countries strongly promote a population shift from car dependency to active transport [4, 5]. In 2008, in order to promote a healthier lifestyle, the Chinese government launched a nationwide program, of which AT is an integral part [6]. However, some studies have reported that AT was related to no or even negative effects on health [7, 8]. As being the largest developing country, China has her unique characteristics concerning transport environment and residents’ transport activity. However, there is little data on these aspects available at present. Jiangsu Province is one of the most economically booming areas in the southeast of China. With a population of 78.66 million, Jiangsu is