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1.
BMC Public Health ; 22(1): 1475, 2022 08 02.
Article in English | MEDLINE | ID: covidwho-1968563

ABSTRACT

BACKGROUND: The COVID-19 pandemic disrupted life in extraordinary ways impacting health and daily mobility. Public transit provides a strategy to improve individual and population health through increased active travel and reduced vehicle dependency, while ensuring equitable access to jobs, healthcare, education, and mitigating climate change. However, health safety concerns during the COVID-19 pandemic eroded ridership, which could have longstanding negative consequences. Research is needed to understand how mobility and health change as the pandemic recedes and how transit investments impact health and equity outcomes. METHODS: The TROLLEY (TRansit Opportunities for HeaLth, Livability, Exercise and EquitY) study will prospectively investigate a diverse cohort of university employees after the opening of a new light rail transit (LRT) line and the easing of campus COVID-19 restrictions. Participants are current staff who live either < 1 mile, 1-2 miles, or > 2 miles from LRT, with equal distribution across economic and racial/ethnic strata. The primary aim is to assess change in physical activity, travel mode, and vehicle miles travelled using accelerometer and GPS devices. Equity outcomes include household transportation and health-related expenditures. Change in health outcomes, including depressive symptoms, stress, quality of life, body mass index and behavior change constructs related to transit use will be assessed via self-report. Pre-pandemic variables will be retrospectively collected. Participants will be measured at 3 times over 2 years of follow up. Longitudinal changes in outcomes will be assessed using multilevel mixed effects models. Analyses will evaluate whether proximity to LRT, sociodemographic, and environmental factors modify change in outcomes over time. DISCUSSION: The TROLLEY study will utilize rigorous methods to advance our understanding of health, well-being, and equity-oriented outcomes of new LRT infrastructure through the COVID-19 recovery period, in a sample of demographically diverse adult workers whose employment location is accessed by new transit. Results will inform land use, transportation and health investments, and workplace interventions. Findings have the potential to elevate LRT as a public health priority and provide insight on how to ensure public transit meets the needs of vulnerable users and is more resilient in the face of future health pandemics. TRIAL REGISTRATION: The TROLLEY study was registered at ClinicalTrials.gov ( NCT04940481 ) June 17, 2021, and OSF Registries ( https://doi.org/10.17605/OSF.IO/PGEHU ) June 24, 2021, prior to participant enrollment.


Subject(s)
COVID-19 , Adult , COVID-19/epidemiology , Humans , Pandemics , Prospective Studies , Quality of Life , Retrospective Studies , Transportation/methods
2.
Health Place ; 71: 102659, 2021 09.
Article in English | MEDLINE | ID: covidwho-1397344

ABSTRACT

Most of the existing literature concerning the links between built environment and COVID-19 outcomes is based on aggregate spatial data averaged across entire cities or counties. We present neighborhood level results linking census tract-level built environment and active/sedentary travel measures with COVID-19 hospitalization and mortality rates in King County Washington. Substantial variations in COVID-19 outcomes and built environment features existed across neighborhoods. Using rigorous simulation-assisted discrete outcome random parameter models, the results shed new lights on the direct and indirect connections between built environment, travel behavior, positivity, hospitalization, and mortality rates. More mixed land use and greater pedestrian-oriented street connectivity is correlated with lower COVID-19 hospitalization/fatality rates. Greater participation in sedentary travel correlates with higher COVID-19 hospitalization and mortality whereas the reverse is true for greater participation in active travel. COVID-19 hospitalizations strongly mediate the relationships between built environment, active travel, and COVID-19 survival. Ignoring unobserved heterogeneity even when higher resolution smaller area spatial data are harnessed leads to inaccurate conclusions.


Subject(s)
Built Environment , COVID-19 , Hospitalization , Humans , SARS-CoV-2 , Walking
3.
Sustain Cities Soc ; 73: 103089, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1267922

ABSTRACT

Compact walkable environments with greenspace support physical activity and reduce the risk for depression and several obesity-related chronic diseases, including diabetes and heart disease. Recent evidence confirms that these chronic diseases increase the severity of COVID-19 infection and mortality risk. Conversely, denser transit supportive environments may increase risk of exposure to COVID-19 suggesting the potential for contrasting chronic versus infectious disease impacts of community design. A handful of recent studies have examined links between density and COVID-19 mortality rates reporting conflicting results. Population density has been used as a surrogate of urban form to capture the degree of walkability and public transit versus private vehicle travel demand. The current study employs a broader range of built environment features (density, design, and destination accessibility) and assesses how chronic disease mediates the relationship between built and natural environment and COVID-19 mortality. Negative and significant relationships are observed between built and natural environment features and COVID-19 mortality when accounting for the mediating effect of chronic disease. Findings underscore the importance of chronic disease when assessing relationships between COVID-19 mortality and community design. Based on a rigorous simulation-assisted random parameter path analysis framework, we further find that the relationships between COVID-19 mortality, obesity, and key correlates exhibit significant heterogeneity. Ignoring this heterogeneity in highly aggregate spatial data can lead to incorrect conclusions with regards to the relationship between built environment and COVID-19 transmission. Results presented here suggest that creating walkable environments with greenspace is associated with reduced risk of chronic disease and/or COVID-19 infection and mortality.

4.
Transport Policy ; 2021.
Article in English | ScienceDirect | ID: covidwho-1081623

ABSTRACT

This study evaluates changes in cycling trips before and after the construction of an urban greenway in Vancouver, Canada. Urban cycling has gained in popularity as a healthy and environmentally friendly mode of transport. Carsharing is also on the rise globally, and it has the potential to disrupt urban mobility, including cycling and public transit. In this study, we hypothesize that cycling trips will increase after the opening of the greenway for residents living within 300 meters of the greenway compared to those living further away. We also posit that carsharing membership will have a positive impact on cycling uptake. Data were drawn from a three-year natural experiment study (2012 to 2015) of the Comox-Helmcken Greenway (“Comox Greenway”) in Vancouver. An experimental-and-control design is employed to compare pre-post differences in cycling trips for residents within 300 meters of the greenway (experimental group, n=239) and those further away (control group, n=285). The opening of the greenway resulted in a 251% increase in cycling trips for the experimental group compared to the control group. Ethnically white subjects reported 130% more cycling trips than non-white subjects, and those aged 65 and older reported 79% fewer cycling trips than younger age cohorts. Carshare membership reduced the number of cycling trips after the greenway opening. Results suggest that greenways could be an effective strategy to boost urban cycling, and that carsharing programs may have a countervailing effect on cycling. The findings support recent initiatives to reappropriate road space in urban areas for cycling and walking due to the COVID-19 pandemic.

5.
Transp Policy (Oxf) ; 103: 68-85, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1051966

ABSTRACT

Impacts of coronavirus disease 2019 (COVID-19) on the transport sector and the corresponding policy measures are becoming widely investigated. Considering the various uncertainties and unknowns about this virus and its impacts (especially long-term impacts), it is critical to understand opinions and suggestions from experts within the transport sector and related planning fields. To date, however, there is no study that fills this gap in a comprehensive way. This paper is an executive summary of the findings of the WCTRS COVID-19 Taskforce expert survey conducted worldwide between the end of April and late May 2020, obtaining 284 valid answers. The experts include those in the field of transport and other relevant disciplines, keeping good balances between geographic regions, types of workplaces, and working durations. Based on extensive analyses of the survey results, this paper first reveals the realities of lockdowns, restrictions of out-of-home activities and other physical distancing requirements, as well as modal shifts. Experts' agreements and disagreements to the structural questions about changes in lifestyles and society are then discussed. Analysis results revealed that our human society was not well prepared for the current pandemic, reaffirming the importance of risk communication. Geographical differences of modal shifts are further identified, especially related to active transport and car dependence. Improved sustainability and resilience are expected in the future but should be supported by effective behavioral intervention measures. Finally, policy implications of the findings are discussed, together with important future research issues.

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