Health Economics Unit, University of Birmingham, Birmingham B15 2TT, UK.
Health Economics, University of Bristol, Bristol BS8 1QU, UK.
Int J Environ Res Public Health. 2022 Oct 24;19(21):13809. doi: 10.3390/ijerph192113809.
Natural environments, such as inland waterways (IWs), have been identified as a potential means to increase physical activity and promote health and wellbeing. However, further information on predictors of IW usage and their relationship with health and wellbeing outcomes is needed. Data were taken from the cross-sectional UK Waterways Engagement Monitor survey of waterway users (n = 21,537) in 2019/2020. Health outcome measures were life satisfaction, physical activity, and mental wellbeing. Visit frequency was an additional outcome measure. Both bivariate and multivariable associations between outcome measures and features of IWs were explored. The travel-cost method was used to estimate users' demand, expressed by travel costs to waterways. Multivariable models showed positive associations of frequent visits and use for recreational/leisure purposes with life satisfaction and physical activity. Rural visits were associated with higher life satisfaction than urban ones. Lower visit satisfaction negatively impacted life satisfaction and mental wellbeing. Visit frequency was influenced by individual characteristics and purpose of visit, including visits for exercise. Waterway visits were inversely associated with travel costs (IRR = 0.99, -value ≤ 0.001), and there was greater demand elasticity for short distances (≤5 miles). Socioeconomic-related inequalities were present. Future policies could enhance frequent use of waterways and alleviate accessibility-related inequalities to improve population health outcomes.
自然环境，如内陆水道（IWs），已被确定为增加身体活动和促进健康和幸福的一种潜在手段。然而，需要更多关于内陆水道使用的预测因素及其与健康和幸福结果的关系的信息。数据取自 2019/2020 年对水道使用者（n = 21,537）进行的横断面英国水道参与监测调查。健康结果衡量标准是生活满意度、身体活动和心理健康。访问频率是另一个结果衡量标准。分别探讨了生活满意度、身体活动和心理健康等结果衡量标准与 IWs 特征之间的双变量和多变量关联。使用旅行成本法来估计用户的需求，即前往水道的旅行成本。多变量模型显示，频繁访问和出于娱乐/休闲目的使用与生活满意度和身体活动呈正相关。农村访问比城市访问与更高的生活满意度相关。较低的访问满意度会对生活满意度和心理健康产生负面影响。访问频率受到个人特征和访问目的的影响，包括因锻炼而进行的访问。水道访问与旅行成本呈负相关（IRR = 0.99，P 值≤0.001），并且较短距离（≤5 英里）的需求弹性更大。存在与社会经济相关的不平等现象。未来的政策可以促进人们更频繁地使用水道，并缓解与可达性相关的不平等现象，从而改善人口健康结果。
