Active commuters are less likely to suffer from heart disease and cancer, new study finds

In a recently published study, BMJ Public Health, The researchers looked at the prospective associations between active commuting and multiple health outcomes over an 18-year period, separately for pedestrians and cyclists.

study: Health benefits of walking and cycling to work: evidence from the Scottish Longitudinal StudyImage credits: PeopleImages.com – Yuri A/Shutterstock.com

background

Regular moderate to vigorous exercise, such as walking or cycling, has great benefits for your physical and mental health.

Evidence suggests that cycling to work, and to a lesser extent walking to work, is associated with a lower risk of morbidity and mortality.

Further research is needed to explore the long-term health effects of active commuting more broadly and understand the underlying mechanisms.

About the Research

This study used data from the Scottish Longitudinal Study (SLS), representing 5.3% of the Scottish population based on the censuses of 1991, 2001 and 2011. Data from hospital admissions, death registration and prescription records were linked using personal identifiers. 2001 was chosen as the reference year as key covariate measures were not available in 1991 and 2011.

Participants aged 16–74 years who travelled to the United Kingdom (UK) for work or study in 2001 were included, excluding the unemployed, overseas workers and those working outside the UK, totalling 114,523 people.

Records of 467 active commuters traveling more than 40.5 km were excluded, as well as 31,759 individuals with missing covariate data. The final sample consisted of 82,297 participants.

As anonymised data were used, patient and public engagement was not applied. Exposure variables were derived from census responses regarding usual mode of travel to work or school, with active travel defined as walking or cycling. Covariates included age, sex, pre-existing health conditions, socioeconomic factors and other potential confounders.

Health outcomes were binary variables over the follow-up period from 2001 to 2018 and included all-cause mortality, hospitalization, cardiovascular disease (CVD), cancer, mental health medication, and hospitalization due to road traffic accidents.

Cox proportional hazards models estimated the association between travel mode and health outcomes after adjusting for covariates. Analyses were conducted using R version 3.6.3 and the “survival package.”

research result

The study followed 82,297 participants from the 2001 Scottish Longitudinal Study up to 2018. During this period, 4,276 participants (5.2% of the cohort) died, and almost half of these deaths (2,023, 2.5%) were due to cancer.

A total of 52,804 (64.2%) were hospitalized, of which 9,663 (11.7%) were due to CVD, 5,939 (7.2%) to cancer, and 2,668 (3.2%) to traffic accidents.

Additionally, 31,666 (38.5%) received a CVD-related prescription between 2009 and 2018, and 33,771 (41%) received a prescription for a psychiatric disorder during the same period.

Descriptive statistics for covariates by commuting mode showed that walking commuters were more likely to be younger, female, shift workers, have shorter commute distances, and live in urban areas compared to non-exercise commuters.

They were less likely to have dependents and generally had lower socio-economic status as measured by educational qualifications, home ownership, occupation and the likelihood of living in an overcrowded household.

Compared to non-bicycle commuters, bicycle commuters were more likely to be younger, male, shift workers, and urban dwellers, and less likely to be homeowners or carers.

Bicycle commuters had significantly lower risks of all-cause mortality (hazard ratio (HR) 0.53, 95% CI 0.38-0.73), CVD hospitalization (HR 0.76, 95% CI 0.64-0.91), any hospitalization (HR 0.90, 95% CI 0.84-0.97), receipt of CVD-related prescriptions (HR 0.70, 95% CI 0.63-0.78), cancer hospitalization (HR 0.76, 95% CI 0.59-0.98), cancer death (HR 0.49, 95% CI 0.30-0.82), and receipt of prescriptions for psychiatric disorders (HR 0.80, 95% CI 0.73-0.89).

There was no clear association between cycling to work and CVD mortality (HR 0.63, 95% CI 0.35 to 1.15). However, cyclists were at higher risk of hospitalisation after a road traffic accident (HR 1.98, 95% CI 1.59 to 2.48), although this was relatively rare, with 83 hospitalisations over the 18-year period.

Walking commuters had lower risk of hospitalization (HR 0.91, 95% CI 0.88-0.93), CVD hospitalization (HR 0.90, 95% CI 0.84-0.96), receipt of CVD-related prescriptions (HR 0.90, 95% CI 0.87-0.93), and possession of prescriptions for psychiatric disorders (HR 0.93, 95% CI 0.90-0.97).

There was no clear evidence of an association between walking to work and all-cause mortality (HR 0.96, 95% CI 0.88 to 1.06), CVD mortality (HR 0.96, 95% CI 0.79 to 1.17), cancer mortality (HR 0.89, 95% CI 0.77 to 1.02), cancer hospitalization (HR 0.98, 95% CI 0.90 to 1.06), or hospitalization after a traffic accident (HR 0.99, 95% CI 0.87 to 1.12).

Conclusion

In summary, this study provides long-term evidence of the health benefits of active commuting in Scotland: cycle commuters were found to have a significantly lower risk of death, hospitalisation, CVD, cancer and mental health problems compared to inactive commuters.

Pedestrians also had a lower risk of hospitalization, cardiovascular disease and mental health problems. Although cyclists are at higher risk of traffic accidents, the overall health benefits outweigh the risks.

These findings are consistent with previous studies and highlight the importance of promoting active travel to improve public health. Increased physical activity through active commuting contributes significantly to these positive health outcomes.