Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom.
Economic and Social Research Council International Centre for Lifecourse Studies, Department of Epidemiology and Public Health, University College London, London, United Kingdom.
Am J Epidemiol. 2019 Apr 1;188(4):785-795. doi: 10.1093/aje/kwz012.
Public transportation provides an opportunity to incorporate physical activity into journeys, but potential health impacts have not been systematically examined. We searched the literature for articles on public transportation and health published through December 2017 using Google (Google Inc., Mountain View, California), 5 medical databases, and 1 transportation-related database. We identified longitudinal studies which examined associations between public transportation and cardiometabolic health (including adiposity, type 2 diabetes mellitus, and cardiovascular disease). We assessed study quality using the Newcastle-Ottawa Scale for cohort studies and performed meta-analyses where possible. Ten studies were identified, 7 investigating use of public transportation and 3 examining proximity to public transportation. Seven studies used individual-level data on changes in body mass index (BMI; weight (kg)/height (m)2), with objective outcomes being measured in 6 studies. Study follow-up ranged from 1 year to 10 years, and 3 studies adjusted for nontransportation physical activity. We found a consistent association between use of public transportation and lower BMI. Meta-analysis of data from 5 comparable studies found that switching from automobile use to public transportation was associated with lower BMI (-0.30 units, 95% confidence interval: -0.47, -0.14). Few studies have investigated associations between public transportation use and nonadiposity outcomes. These findings suggest that sustainable urban design which promotes public transportation use may produce modest reductions in population BMI.
公共交通为在出行中融入身体活动提供了机会，但尚未对其潜在的健康影响进行系统研究。我们通过谷歌（加利福尼亚州山景城的谷歌公司）、5 个医学数据库和 1 个交通相关数据库，搜索了截至 2017 年 12 月发表的有关公共交通与健康的文献。我们确定了对公共交通与心血管代谢健康（包括肥胖、2 型糖尿病和心血管疾病）之间关联进行纵向研究的文章。我们使用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）对队列研究进行了研究质量评估，并在可能的情况下进行了荟萃分析。确定了 10 项研究，其中 7 项研究调查了公共交通的使用情况，3 项研究调查了公共交通的接近程度。有 7 项研究使用了个体层面上关于体重指数（BMI；体重（kg）/身高（m）2）变化的数据，其中 6 项研究对客观结果进行了测量。研究随访时间从 1 年到 10 年不等，有 3 项研究对非交通方式的体力活动进行了调整。我们发现，使用公共交通与 BMI 降低之间存在一致的关联。对 5 项可比研究的数据进行的荟萃分析发现，从使用汽车改为使用公共交通与 BMI 降低有关（-0.30 个单位，95%置信区间：-0.47，-0.14）。很少有研究调查过公共交通使用与非肥胖结局之间的关联。这些发现表明，促进公共交通使用的可持续城市设计可能会使人群 BMI 适度降低。
