• Abstract and Figures
• Public Full-text

Pan American Journal Systematic review of Public Health Prevalence of active transportation among adults in Latin America and the Caribbean: a systematic review of population-based studies Thiago Hérick de Sá,1 Leandro Fórnias Machado de Rezende,2 Maria Carolina Borges,3 Priscila Missaki Nakamura,4 Sebastian Anapolsky,5 Diana Parra,6 Fernando Adami,7 and Carlos Augusto Monteiro1 Suggested citation de Sá TH, Rezende LFM, Borges MC, Nakamura PM, Anapolsky S, Parra D, et al. Prevalence of active transportation among adults in Latin America and the Caribbean: a systematic review of population- based studies. Rev Panam Salud Publica. 2017;41:e35. ABSTRACT Objective. To describe the prevalence of “active” (self-propelled, human-powered) transporta- tion in the Latin America and Caribbean (LAC) region over the past decade. Methods. MEDLINE, Excerpta Medica (Embase), SportDiscus, Lilacs, MediCarib, Web of Science, OVID, CINAHL, Scopus, Google Scholar, National Transportation Library, and TRIS/TRID were searched for articles on active transportation published between January 2003 and December 2014 with (at least) a title and abstract in English, Portuguese, or Spanish. Research was included in the study if the two reviewing authors agreed it 1) was conducted in an adult sample (≥ 18 years old), 2) was designed to be representative of any LAC area, and 3) reported at least one measure of active transportation. Reference lists of included papers and retrieved reviews were also checked. A total of 129 key informants (87 scientific experts and 42 government authorities) were contacted to identify additional candidate publications. Two other authors extracted the data independently. Results. A total of 10 459 unique records were found; the full texts of 143 were reviewed; and a total of 45 studies were included in the study, yielding estimates for 72 LAC settings, most of which were in Argentina, Brazil, and Colombia. No eligible studies were found for the years 2003–2004, resulting in a 10-year study time frame. Estimates were available for walking, cycling, or the combination of both, with a high degree of heterogeneity (heterogeneity index (I2) ≥ 99%). The median prevalence of active transportation (combining walking and cycling) was 12.0%, ranging from 5.1% (in Palmas, Brazil) to 58.9% (in Rio Claro, Brazil). Men cycled more than women in all regions for which information was available. The opposite was true for walking. Conclusions. Prevalence of active transportation in LAC varied widely, with great heteroge- neity and uneven distribution of studies across countries, indicating the need for efforts to build comprehensive surveillance systems with standardized, timely, and detailed estimates of active transportation in order to support policy planning and evaluation. Keywords Urban health; healthy city; transportation; walking; motor vehicles; Argentina; Brazil; Colombia; Latin America; Caribbean Region. 1 Department of Nutrition, School of Public Health, 3 Postgraduate program in Epidemiology, 6 Program in Physical Therapy, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil. Universidade Federal de Pelotas, Pelotas, RS, Brazil. Washington University in St. Louis, St. Louis, Send correspondence to: Thiago Hérick de Sá, 4 Postgraduate program in Motor Science, United States of America. [email protected] Universidade Estadual Paulista Júlio de Mesquita 7 Laboratório de Epidemiologia e Análise de 2 Department of Preventive Medicine, School of Filho Rio Claro, SP, Brazil. Dados, Faculdade de Medicina do ABC, Santo Medicine, Universidade de São Paulo, São Paulo, 5 Independent Consultant, Buenos Aires, BA, André, SP, Brazil. SP, Brazil. Argentina. Rev Panam Salud Publica 41, 2017 1 Systematic review de Sá et al. • Active transportation among adults in Latin America and the Caribbean In September 2015, heads of state particularly for walking and cycling, as Abstracts, and EBM reviews), CINAHL, joined in the United Nations General As- these modes of transportation were tra- Scopus, Google Scholar, National Trans- sembly to discuss the implementation of ditionally relegated to a secondary role portation Library, and TRIS/TRID were a new set of goals post-2015—the Sus- in both health and transportation re- searched for articles on active transporta- tainable Development Goals (SDGs)— search (11). Failing to promote and mon- tion published between January 2003 designed to build upon the health gains itor different levels of walking and and December 2014 with (at least) a title obtained from the Millennium Develop- cycling as well as other forms of active and abstract in English, Portuguese, or ment Goals (MDGs) experience (1). The transportation might jeopardize efforts Spanish. The previous decade was se- new agenda includes thematic areas, supporting that agenda in the SDG era, lected as the study period to obtain up-to- such as city development and energy, as has already been learned from the date estimates that covered a time frame and key components promoting holistic MDGs experience, in which limitations relevant for policy planning. Search terms and integrated responses, designed to arose related to a lack of data related to included variations of the following terms achieve a healthier future, including various criteria, including targets linked in English, Portuguese, and Spanish: epi- “safe, affordable, accessible and sustain- with sustainable healthy environments demiology, prevalence, rate, active travel, ac- able transport systems for all” (SDG 11, (e.g., Target C of MDG 7: “Ensure Envi- tive transportation, active commuting, urban Target 11.2) (1). Sustainable transporta- ronmental Sustainability”) (2). mobility, running, walking, pedestrian, cy- tion systems are also in line with several Across and within countries the LAC cling, bicycle, bike, paddling, rowing, travel targets from health-specific SDG 3, such region has 1) marked differences in ac- survey, transport survey, demand survey, as halving the number of global deaths tive transportation and 2) varied capac- origin and destination, mobility survey, time- and injuries from road traffic, and sub- ity to promote changes in transportation use survey, adult, men, women, Latin Amer- stantially reducing deaths and illnesses systems and/or provide representative ica, Central America, South America, Caribe, from air pollution (1), highlighting the estimates of prevalence. Despite recent and names of LAC countries. Searches importance of cross-cutting cooperation. efforts to compile these estimates, partic- included truncated and full-text terms as “Active” (self-propelled, human-pow- ularly for cycling (12), most of the avail- well as MeSH (medical subject heading) ered) transportation is a key component able information is limited to the descriptors and their equivalents. The for the development of healthy sustain- proportion of trips taken by type of ac- search strategy was adapted from the able environments as it provides health tive transportation, which is not an opti- search of Saunders et al. (15), then ad- benefits as well as ancillary benefits re- mum indicator for public health justed for each database used, and is lated to greenhouse gas emissions (2, 3). monitoring, with very few studies col- available from the corresponding author Moreover, increasing active transportation lecting data on the prevalence of active (THS). levels is a key population-wide strategy to transportation across the region. To help The reference list of all selected man- reverse the burden of noncommunicable fill this gap, the objective of this study uscripts was reviewed and relevant re- diseases (NCDs), given the great potential was to describe the prevalence of active views identified through the search and of tackling physical inactivity levels transportation in the LAC region over selection processes. A total of 129 key through the transportation sector (4). This the past decade. informants (87 scientific experts and 42 is particularly important for low- and government authorities) were contacted middle-income countries (LMICs) be- MATERIALS AND METHODS by email to find any additional studies cause they have the highest burden of (including unpublished or ongoing re- NCDs relative to other regions (5), rein- A systematic review of popula- search) that might be relevant for the forcing historical health inequities. tion-based studies reporting the preva- review. All contacts by email included The Latin America and Caribbean lence of any type of active transportation an initial email, followed by, in the case (LAC) region, which has undergone rapid in the LAC region was performed in of no response, two follow-up emails urbanization, includes many LMICs with accordance with PRISMA8 guidelines sent within two and three weeks respec- significant challenges in terms of trans- (13) and guidance for health care re- tively. When email was not available, portation and urban planning (6). More- views developed by the University of the key informants had their website over, despite being, overall, the most York’s Centre for Reviews and Dissemi- searched for the same purpose (to find urbanized region in the world, with 80% nation (CRD) (York, England) (14). Ac- additional studies). Duplicate records of the population living in cities (7), LAC tive transportation was defined as any were removed using EndNote™ online includes countries at different levels of self-propelled, human-powered mode (formerly EndNote Web) (Thomson urbanization and at different stages in the of

Load more

  11

Copy Link