Outlook: Newsletter of the Society of Behavorial Medicine

Summer 2022

Slowing Climate Change: How Active Transport Can Benefit Your Environment and Your Health

Nashira I. Brown, MS; Erica A. Schleicher, MS; Kyle I Kershner, MS; Diane K. Ehlers, PhD; Angela J. Fong, PhD; and Dori Pekmezi, PhD; Physical Activity SIG

Benefits of Active Transportation for Climate Change and Public Health

Increasing active transportation (AT; e.g., walking, bicycling, public transit) can reduce the impact humans are having on climate change and improve both individual and public health.1-5 AT has been associated with improved health outcomes (e.g., quality of life, aerobic fitness, decreased risk of chronic diseases, in addition to executive function and cognition),6,7 and increased longevity.3,8 U.S. data indicates that AT is associated with more adults meeting recommended levels of physical activity, 9-12 and lower prevalence of obesity and diabetes.4,7,13,14 AT also benefits the environment by reducing greenhouse gas emissions associated with car-based transit (e.g., dioxide equivalent).3,15 Previous research shows programs promoting AT can help combat climate change by decreasing air pollutants and protecting environmental resources (e.g., less gas consumption).15,16 Thus, AT is uniquely situated to address public health concerns related to both climate change17 and a sedentary lifestyle.18,19

Prevalence of Active Transportation (and Challenges)

Despite the environmental and health benefits, AT rates in the U.S. (4-16%) are lower than many other developed nations (34.9- 37.9% in France and the Netherlands), likely due to mixed land use, car-free zones, traffic regulations that support cyclists and pedestrians, and public transportation availability.20 Within the US, there are rural-urban differences,21 with higher AT rates in urban areas where frequented locations such as schools and grocery stores are within close proximity (e.g., 20-minute bicycle ride).22 Conversely, in rural areas, AT infrastructure (e.g., sidewalks, bike lanes, pedestrian crossings) are often lacking,23 and grocery stores, jobs, and schools are typically located more than 20 miles from home.24 Subsequently, “car culture,” or excessive use/reliance on motor vehicles, remains dominant in rural regions25 and likely contributes to existing rural health disparities. Thus, a multi-level approach will be needed to effectively promote AT.

Strategies for Encouraging Active Transport

Multi-level approaches promoting AT include individual/interpersonal level behavioral strategies along with policy and environmental changes.2 Interventions targeting interpersonal/organizational levels (e.g., improving AT knowledge and attitudes among office employees) have increased physical activity and decreased car-based transit.26-28 Effective interpersonal/organizational interventions promote AT by creating rich social atmospheres where AT is encouraged through AT-based social events, organization-wide AT marketing, personalized AT plans, and addressing individual barriers for AT.28,29  These efforts can be augmented by government campaigns to increase accessibility/awareness of safe and reliable AT options (e.g., light rail signage30 and street connectivity/housing density1), mixed land-use (e.g., residential developments incorporating spaces for work/shopping/recreation),31 and publicly available AT equipment renting options (e.g., public bike/scooter renting programs).32

Grassroots organizations can add to these interventions by encouraging the use of public transit and creating infrastructure promoting AT.33 For example, Bike Walk Nebraska34 and Heartland Bike Share35 have collaborated with schools to educate families on safe cycling routes to schools, institutions/businesses to offer free bike rentals to employees, and government to add protected bike lanes. Similar programs may include promoting financial incentives/disincentives (e.g., free bike renting or road-use tolls),36 city-wide AT equipment (e.g., bikes, scooters) renting,32 and inserting “greenway systems” connecting urban, suburban, and rural communities via walking/cycling trails.37

Individuals interested in AT should begin by identifying safe routes to walk, bike, or scooter to frequented destinations and seek local renting stations for AT-related equipment (e.g., bike sharing stations). Higher level promotion of AT can be accomplished through appealing to government officials (e.g., urban planners) to affect policy and infrastructure planning, joining local, state, and national organizations (e.g., the Active Transport Alliance,38 Safe Routes Partnership39) If done concomitantly, these policy, environmental, and individual-level interventions have the potential to increase AT and thereby promote reductions in climate change and improved health.

Here are some useful resources/websites for those interested in starting their AT journey:



  1. Young DR, Cradock AL, Eyler AA, et al. Creating Built Environments That Expand Active Transportation and Active Living Across the United States: A Policy Statement From the American Heart Association. Circulation. 2020;142(11):e167-e183.
  2. Nigg C, Nigg CR. It's more than climate change and active transport-physical activity's role in sustainable behavior. Transl Behav Med. 2021;11(4):945-953.
  3. Alessio HM, Bassett DR, Bopp MJ, et al. Climate Change, Air Pollution, and Physical Inactivity: Is Active Transportation Part of the Solution? Med Sci Sports Exerc. 2021;53(6):1170-1178.
  4. Pucher J, Dijkstra L. Promoting safe walking and cycling to improve public health: lessons from The Netherlands and Germany. Am J Public Health. 2003;93(9):1509-1516.
  5. Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39(8):1435-1445.
  6. Erickson KI, Hillman C, Stillman CM, et al. Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines. Med Sci Sports Exerc. 2019;51(6):1242-1251.
  7. Pucher J, Buehler R, Bassett DR, Dannenberg AL. Walking and cycling to health: a comparative analysis of city, state, and international data. Am J Public Health. 2010;100(10):1986-1992.
  8. Andersen LB, Schnohr P, Schroll M, Hein HO. All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Arch Intern Med. 2000;160(11):1621-1628.
  9. Besser LM, Dannenberg AL. Walking to public transit: steps to help meet physical activity recommendations. Am J Prev Med. 2005;29(4):273-280.
  10. Piercy KL, Troiano RP, Ballard RM, et al. The Physical Activity Guidelines for Americans. Jama. 2018;320(19):2020-2028.
  11. Freeland AL, Banerjee SN, Dannenberg AL, Wendel AM. Walking associated with public transit: moving toward increased physical activity in the United States. Am J Public Health. 2013;103(3):536-542.
  12. Yu CY, Wang B. Moving Toward Active Lifestyles: The Change of Transit-Related Walking to Work From 2009 to 2017. J Phys Act Health. 2020;17(2):189-196.
  13. Gordon-Larsen P, Boone-Heinonen J, Sidney S, Sternfeld B, Jacobs DR, Jr., Lewis CE. Active commuting and cardiovascular disease risk: the CARDIA study. Arch Intern Med. 2009;169(13):1216-1223.
  14. Huy C, Becker S, Gomolinsky U, Klein T, Thiel A. Health, medical risk factors, and bicycle use in everyday life in the over-50 population. J Aging Phys Act. 2008;16(4):454-464.
  15. Nigg C, Nigg CR. It’s more than climate change and active transport—physical activity’s role in sustainable behavior. Transl Behav Med. 2021;11(4):945-953.
  16. Kou Z, Wang X, Chiu SF, Cai H. Quantifying greenhouse gas emissions reduction from bike share systems: a model considering real-world trips and transportation mode choice patterns. Resources, Conservation and Recycling. 2020;153:104534.
  17. Environmental Protection Agency. Our Nation’s Air. https://gispub.epa.gov/air/trendsreport/2021 Published 2021. Accessed May 23, 2022.
  18. Wilson DK. Behavior matters: the relevance, impact, and reach of behavioral medicine. Ann Behav Med. 2015;49(1):40-48.
  19. Kim J, Conroy DE, Smyth JM. Bidirectional Associations of Momentary Affect with Physical Activity and Sedentary Behaviors in Working Adults. Ann Behav Med. 2020;54(4):268-279.
  20. Bassett DR, Jr., Pucher J, Buehler R, Thompson DL, Crouter SE. Walking, cycling, and obesity rates in Europe, North America, and Australia. J Phys Act Health. 2008;5(6):795-814.
  21. United States Department of Agriculture. Rural Classifications. https://www.ers.usda.gov/topics/rural-economy-population/rural-classifications/. Published 2021. Accessed May 23, 2022.
  22. Partnership for Active Transportation. Why Active Transportation  https://www.railstotrails.org/partnership-for-active-transportation/why/ Published 2018. Accessed May 23, 2022.
  23. Fan JX, Wen M, Wan N. Built Environment and Active Commuting: Rural-Urban Differences in the U.S. SSM Popul Health. 2017;3:435-441.
  24. Jilcott SB, Liu H, Moore JB, Bethel JW, Wilson J, Ammerman AS. Commute times, food retail gaps, and body mass index in North Carolina counties. Prev Chronic Dis. 2010;7(5):A107.
  25. Lexico. Car Culture. In. Oxford University Press 2022.
  26. Xu H, Wen LM, Rissel C. The relationships between active transport to work or school and cardiovascular health or body weight: a systematic review. Asia Pac J Public Health. 2013;25(4):298-315.
  27. Jones RA, Blackburn NE, Woods C, Byrne M, van Nassau F, Tully MA. Interventions promoting active transport to school in children: A systematic review and meta-analysis. Prev Med. 2019;123:232-241.
  28. Wen LM, Orr N, Bindon J, Rissel C. Promoting active transport in a workplace setting: evaluation of a pilot study in Australia. Health Promot Int. 2005;20(2):123-133.
  29. Brockman R, Fox KR. Physical activity by stealth? The potential health benefits of a workplace transport plan. Public Health. 2011;125(4):210-216.
  30. Lanza K, Oluyomi A, Durand C, et al. Transit environments for physical activity: Relationship between micro-scale built environment features surrounding light rail stations and ridership in Houston, Texas. J Transp Health. 2020;19:100924.
  31. Mumford KG, Contant CK, Weissman J, Wolf J, Glanz K. Changes in physical activity and travel behaviors in residents of a mixed-use development. Am J Prev Med. 2011;41(5):504-507.
  32. Clockston RLM, Rojas-Rueda D. Health impacts of bike-sharing systems in the U.S. Environ Res. 2021;202:111709.
  33. Litman T. Are vehicle travel reduction targets justified. Evaluating Mobility Management Policy Objectives Such As Targets To Reduce VMT And Increase Use Of Alternative Modes' Victoria Transport Policy Institute. 2009.
  34. Nebraska BW. Who We Are : History and Accomplishments. https://www.bikewalknebraska.org/who-we-are/history.html Published 2022. Accessed May 23, 2022.
  35. BCycle. H. In the Community. https://heartland.bcycle.com. Published 2015. Accessed May 23, 2022.
  36. Shill GH. Should law subsidize driving? New York University law review (1950). 2020;95(2):498-579.
  37. Smith M, Hosking J, Woodward A, et al. Systematic literature review of built environment effects on physical activity and active transport – an update and new findings on health equity. International Journal of Behavioral Nutrition and Physical Activity. 2017;14(1):158.
  38. Active Transportation Alliance. Our Work. https://activetrans.org/our-work. Published 2022. Accessed May 23, 2022.
  39. Safe Routes Partnership. Safe Routes to School https://www.saferoutespartnership.org/safe-routes-school. Published 2022. Accessed May 23, 2022.