Active Transportation and Planetary Health

Original Editor - Carin Hunter based on the course by Adam Toner
Top Contributors - Carin Hunter, Jess Bell, Wanda van Niekerk, Kim Jackson, Tarina van der Stockt, Lucinda hampton and Olajumoke Ogunleye

What is Planetary Health?

Human health and our own existence depend on flourishing natural systems and that these stewardship of these systems and helping them thrive help us thrive to. Physiotherapy is widely recognised as being an important stakeholder in population health. Planetary health itself is seen as it's a growing and an important part of population health.

What is Active Transport?

Active Transport is defined as:

• walking
• cycling
• scooters
• jogging

Active transport can be anything that involves physical activity to or from a place of work or school. If an individual uses public transport, walking or biking to that stop is defined as active transport. We see it as a planetary health intervention. If physiotherapy, as a profession, can help to increase active transportation, we might also see an increase in physical activity, which will simultaneously have a positive impact on the environment.

Table representing the interaction between the physiotherapist, active transportation, human health and the environment

the interaction between the physiotherapist, active transportation, human health and the environment, maybe we'll be able to see a little bit more about how we fit in as a profession when it comes to planetary health.

a) The interaction between physiotherapist and human health

. So if you think of the individual who has a health problem, let's say an injury, they themselves are going to go seek a physiotherapist possibly, and that physiotherapist is going to have an impact on their health by supporting their own improvements, whether that be educating them, giving them certain advice, obviously administering interventions or giving them an exercise program.

b) The interaction between the physiotherapist and active transportation

. So active transportation might allow access to physiotherapy for patients. And also the physical therapist, we might be able to promote active transportation as a way for a patient to increase their own physical activity.

c) The interaction between the physiotherapist and the environment

. Now, in this case, we mean more of the built environment, not the natural environment as such. And what we mean by that is the physiotherapist might advocate for changes in the built environment in such a way that it might help access to physiotherapy or might help access to other facilities that are important to that patient. The built environments itself will affect PT access and will affect access to certain health facilities, certain areas to exercise for the patient as well.

d) The interaction between active transport and human health

. So what we're hypothesising is that if we increase someone's active transportation, that in itself is going to increase their physical activity, which will have a positive impact on their health. However, poor health,  starting off with some poor health might itself be a barrier to engaging in active transportation.

e) The interaction between active transport and the environment

. In this case, we're talking about both the built and the natural environment. So if we get people to engage more in active transportation and increase their physical activity that way, this may have an impact positively on the environment by helping to reduce emissions through perhaps less private car use. And on top of that as well, the environment itself has gone to interact with that person's ability to engage in active transportation. So the environment in which they live in or where they want to exercise can easily encourage or put people off wanting to exercise and to use active transportation as a measure to increase their physical activity.

f) The interaction between human health and the environment

. So we know biodiversity loss can adversely impact upon human health. And opposite to this we know a reduction in human health might adversely impact on the environment. So think of things like lifestyle choices that might involve overconsumption of things, whether that be medical supplies, pharmaceuticals, things like that. And even if we look around today because of the COVID-19 pandemic, and the increased use of masks, disposable masks, I think a lot of us are starting to see more of littering of these masks. So where our own health is impacted, this can have a direct impact on the environment too.

Recommendations
Encourage active transport as a form of PA to improve individual and population health while yielding, additional health-related environmental benefits.
Educate physiotherapists and patients alike about the link between active transport, environment, personal and public health.
Advocate for safe and better infrastructure for active transport.
Advocate for more green spaces and less motorized streets without furthering socio-economic divides.
Advocate for active transport routes in close proximity to biodiverse green spaces, and blue spaces.
Advocate to make e-bikes and bike-share facilities more accessible to those populations that are unable to afford them but need them the most.
Advocate for better integration of active transport with sustainable public transport in a way that ensures physical and financial accessibility.

Interventions	Considerations
Encourage active transport to increase physical activity levels	Are patients open to learning about required physical activity levels?
	Is active transportation cost-effective for the patient?
	Are patients aware of local transportation links and bicycle routes?
	Does the patient have safety concerns preventing active transport as an option as a result of their age, inability, gender, surrounding infrastructure?
Promote positive lifestyle changes through active transportation.	Could adopting active transportation increase the patient’s social interactions?
	Could improved sleep occur as a result of increased activity levels?
	Would adopting active transportation reduce stress in the patient’s life?