[Mobility and Urban Health].

Cities and communities form complex microcosms in which people with very different needs and opportunities live. The structural design and functionality of urban spaces have a significant impact on individual mobility and thus on the health and quality of life of the entire population. In recent decades, politicians and municipalities have accepted negative effects on people (especially vulnerable groups) and ecosystems as a price worth paying for ensuring mobility through car-friendly structures.

Advancing urban green and blue space contributions to public health.

Urban green and blue spaces (UGBS) have the potential to improve public health and wellbeing, address health inequities, and provide co-benefits for the environment, economy, and society. To achieve these ambitions, researchers should engage with communities, practitioners, and policy makers in a virtuous circle of research, policy, implementation, and active citizenship using the principles of co-design, co-implementation, co-evaluation, and co-translation. This Viewpoint provides an integrated perspective on the challenges that hinder the delivery of health-enhancing UGBS and recommendations to address them.

The Health Economic Assessment Tool (HEAT) for walking and cycling - experiences from 10 years of application of a health impact assessment tool in policy and practice.

Introduction: In recent years, walking and cycling have moved into the focus as promising approaches to achieve public health, sustainable transport, climate goals and better urban resilience. However, they are only realistic transport and activity options for a large proportion of the population when they are safe, inclusive and convenient. One way to increase their recognition in transport policy is the inclusion of health impacts of walking and cycling into transport economic appraisals.

The price of precision: trade-offs between usability and validity in the World Health Organization Health Economic Assessment Tool for walking and cycling.

Objectives: The widely used World Health Organization (WHO) Health Economic Assessment Tool (HEAT) for walking and cycling quantifies health impacts in terms of premature deaths avoided or caused as a result of changes in active transport. This article attempts to assess the effect of incorporating 'life-years' as an impact measure to increase the precision of the model and assess the effect on the tool's usability.

Study Design: This article is a methods paper, using simulation to estimate the effect of a methodological change to the HEAT 4.

Assessing the Policy Environment for Active Mobility in Cities-Development and Feasibility of the PASTA Cycling and Walking Policy Environment Score.

The importance of setting a policy focus on promoting cycling and walking as sustainable and healthy modes of transport is increasingly recognized. However, to date a science-driven scoring system to assess the policy environment for cycling and walking is lacking. In this study, spreadsheet-based scoring systems for cycling and walking were developed, including six dimensions (cycling/walking culture, social acceptance, perception of traffic safety, advocacy, politics and urban planning).

Integrated Impact Assessment of Active Travel: Expanding the Scope of the Health Economic Assessment Tool (HEAT) for Walking and Cycling.

The World Health Organization's Health Economic Assessment Tool (HEAT) for walking and cycling is a user-friendly web-based tool to assess the health impacts of active travel. HEAT, developed over 10 years ago, has been used by researchers, planners and policymakers alike in appraisals of walking and cycling policies at both national and more local scales. HEAT has undergone regular upgrades adopting the latest scientific evidence.

Cyclist crash rates and risk factors in a prospective cohort in seven European cities.

Increased cycling uptake can improve population health, but barriers include real and perceived risks. Crash risk factors are important to understand in order to improve safety and increase cycling uptake. Many studies of cycling crash risk are based on combining diverse sources of crash and exposure data, such as police databases (crashes) and travel surveys (exposure), based on shared geography and time.

Correlates of Walking for Travel in Seven European Cities: The PASTA Project.

Background: Although walking for travel can help in reaching the daily recommended levels of physical activity, we know relatively little about the correlates of walking for travel in the European context.

Objective: Within the framework of the European Physical Activity through Sustainable Transport Approaches (PASTA) project, we aimed to explore the correlates of walking for travel in European cities.

Methods: The same protocol was applied in seven European cities.

The development of the Comprehensive Analysis of Policy on Physical Activity (CAPPA) framework.

Background: Policy analysis is considered essential for achieving successful reforms in health promotion and public health. The only framework for physical activity (PA) policy analysis was developed at a time when the field of PA policy research was in its early stages. PA policy research has since grown, and our understanding of what elements need to be included in a comprehensive analysis of PA policy is now more refined.

A global systematic scoping review of studies analysing indicators, development, and content of national-level physical activity and sedentary behaviour policies.

Background: National policy approaches to physical activity (PA) promotion and sedentary behaviour (SB) reduction are needed to address rising rates of non-communicable diseases. Understanding the policy process and impact through robust research and evaluation is crucial for facilitating successful reforms in national health policy. This scoping review, therefore, aimed to map the evidence on indicators, development, and content of national PA and/or SB policies globally.

The effects of transport mode use on self-perceived health, mental health, and social contact measures: A cross-sectional and longitudinal study.

Background: Transport mode choice has been associated with different health risks and benefits depending on which transport mode is used. We aimed to evaluate the association between different transport modes use and several health and social contact measures.

Methods: We based our analyses on the Physical Activity through Sustainable Transport Approaches (PASTA) longitudinal study, conducted over a period of two years in seven European cities.

Transport mode choice and body mass index: Cross-sectional and longitudinal evidence from a European-wide study.

Background: In the fight against rising overweight and obesity levels, and unhealthy urban environments, the renaissance of active mobility (cycling and walking as a transport mode) is encouraging. Transport mode has been shown to be associated to body mass index (BMI), yet there is limited longitudinal evidence demonstrating causality. We aimed to associate transport mode and BMI cross-sectionally, but also prospectively in the first ever European-wide longitudinal study on transport and health.

Promoting health-enhancing physical activity in Europe: Current state of surveillance, policy development and implementation.

This study aims to present information on the surveillance, policy developments, and implementation of physical activity policies in the 28 European Union (EU) countries. Data was collected on the implementation of the EU Recommendation on health-enhancing physical activity (HEPA) across sectors. In line with the monitoring framework proposed in the Recommendation, a questionnaire was designed to capture information on 23 physical activity indicators.

Health impact assessment of cycling network expansions in European cities.

We conducted a health impact assessment (HIA) of cycling network expansions in seven European cities. We modeled the association between cycling network length and cycling mode share and estimated health impacts of the expansion of cycling networks. First, we performed a non-linear least square regression to assess the relationship between cycling network length and cycling mode share for 167 European cities.

Physical activity and sedentary behaviour in daily life: A comparative analysis of the Global Physical Activity Questionnaire (GPAQ) and the SenseWear armband.

Reduction of sedentary time and an increase in physical activity offer potential to improve public health. However, quantifying physical activity behaviour under real world conditions is a major challenge and no standard of good practice is available. Our aim was to compare the results of physical activity and sedentary behaviour obtained with a self-reported instrument (Global Physical Activity Questionnaire (GPAQ)) and a wearable sensor (SenseWear) in a repeated measures study design.

Can air pollution negate the health benefits of cycling and walking?

Active travel (cycling, walking) is beneficial for the health due to increased physical activity (PA). However, active travel may increase the intake of air pollution, leading to negative health consequences. We examined the risk-benefit balance between active travel related PA and exposure to air pollution across a range of air pollution and PA scenarios.

Three types of scientific evidence to inform physical activity policy: results from a comparative scoping review.

Objectives: This paper presents a typology of available evidence to inform physical activity policy. It aims to refine the distinction between three types of evidence relating to physical activity and to compare these types for the purpose of clarifying potential research gaps.

Methods: A scoping review explored the extent, range and nature of three types of physical activity-related evidence available in reviews: (I) health outcomes/risk factors, (II) interventions and (III) policy-making.

Physical Activity through Sustainable Transport Approaches (PASTA): a study protocol for a multicentre project.

Introduction: Only one-third of the European population meets the minimum recommended levels of physical activity (PA). Physical inactivity is a major risk factor for non-communicable diseases. Walking and cycling for transport (active mobility, AM) are well suited to provide regular PA.

Physical Activity through Sustainable Transport Approaches (PASTA): protocol for a multi-centre, longitudinal study.

Background: Physical inactivity is one of the leading risk factors for non-communicable diseases, yet many are not sufficiently active. The Physical Activity through Sustainable Transport Approaches (PASTA) study aims to better understand active mobility (walking and cycling for transport solely or in combination with public transport) as an innovative approach to integrate physical activity into individuals' everyday lives. The PASTA study will collect data of multiple cities in a longitudinal cohort design to study correlates of active mobility, its effect on overall physical activity, crash risk and exposure to traffic-related air pollution.

Health impact assessment of active transportation: A systematic review.

Objective: Walking and cycling for transportation (i.e. active transportation, AT), provide substantial health benefits from increased physical activity (PA).

National physical activity recommendations: systematic overview and analysis of the situation in European countries.

Background: Developing national physical activity (PA) recommendations is an essential element of an effective national approach to promote PA.

Methods: Systematic overview and analysis of national PA recommendations across the European Region of the World Health Organization (WHO). The WHO European national information focal points provided information which was complemented through online searches and input from other experts.

Systematic review and meta-analysis of reduction in all-cause mortality from walking and cycling and shape of dose response relationship.

Background And Objective: Walking and cycling have shown beneficial effects on population risk of all-cause mortality (ACM). This paper aims to review the evidence and quantify these effects, adjusted for other physical activity (PA).

Data Sources: We conducted a systematic review to identify relevant studies.

Turning the tide: national policy approaches to increasing physical activity in seven European countries.

Background: Physical inactivity is one of the four leading behavioural risk factors for non-communicable disease (NCD). Like tobacco control, increasing levels of health-enhancing physical activity (HEPA) will require a national policy framework providing direction and a clear set of actions. Despite frequent calls, there has been insufficient progress on policy development in the majority of countries around the world.

National policy on physical activity: the development of a policy audit tool.

Background: Physical inactivity is a leading risk factor for noncommunicable disease worldwide. Increasing physical activity requires large scale actions and relevant, supportive national policy across multiple sectors.

Methods: The policy audit tool (PAT) was developed to provide a standardized instrument to assess national policy approaches to physical activity.