Dr Adrian Davis
Top line: Public funding enabling free bus travel for older persons may confer significant population health benefits through increased incidental physical activity. These potential benefits appear to be equitably distributed across socio-economic groups and this fact may make the intervention attractive in terms of public policy goals to reduce inequalities.
Physical activity levels are decreasing globally. In 2008, 31% of people worldwide were insufficiently active contributing to 3.2 million deaths each year related to physical activity deficiency. Remaining physically active is as important in older as in younger adults because it reduces the risk of loss of mobility and muscle strength, falls, and fractures, and promotes social and mental well-being. Incidental physical activity may be defined as physical activity that is a by-product of an activity with a different primary purpose. There is increasing interest in the promotion of incidental physical activity, including greater use of active transport—walking, cycling, and use of public transport.
Research into the impact of increasing use of public transport has expanded in the past decade and there is now a small literature which suggests that more public transport use leads to more active travel, principally walking.1 In a study of the National Bus Pass, introduced in 2006, which permits free local bus travel for adults aged 60+ in England, researchers sought to assess the potential public health benefits that might have arisen through an increase in total physical activity.2 Using National Travel Survey data, the main findings suggest that older persons in England with a National Bus Pass are significantly more likely to report active transport use and frequent walking. The findings also indicate that the public health benefit of the bus pass appears to be similar in different socioeconomic groups.
Previous research has suggested that price makes a difference to transport choice and frequency of use, particularly among those of lower socio-economic groups. Free bus pass eligibility is associated with a 50% higher likelihood of using public transport in England and 40% of trips on public transport by pensioners in the West Midlands would not have been undertaken without the concessionary pass, with the majority of travel for shopping trips by those on low incomes.3
The National Bus Pass was introduced in 2006, and a corresponding increase in the number of persons with passes has been seen since this time, though there is also a reduction in overall use in all active transport and bus use. This may suggest that increasing the number of people with passes is not sufficient to compensate for the overall downward trend in active travel in both groups separately. Nevertheless, the researchers demonstrated that those with passes undertake more activity than those without a pass, thereby underscoring the policy’s health benefit.
1 For example, see www.bristol.gov.uk/tpevidencebase No.28
2 Coronini-Cronberg, S., Millet, C., Laverty, A., Webb, E. 2012 The impact of a free older persons’ bus pass on active travel and regular walking in England, American Journal of Public Health, 102(11): 21412148.
3 Webb, E., Netuveli, G., Millet, C. 2011 Free bus passes, use of public transport and obesity among older people in England. Journal of Epidemiology and Community Health, 66: 176-180.