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SDOH: Public Transport

WHO?

- Elderly, PWDs, Minorities and Immigrants.

- 1 in 10 Americans use PT daily.

- Low income/Black/Hispanic/Immigrants

- Lower automobile access

- Live further away from jobs

WHO?

PT, BMI & Body Fat %

HOW?

Associations between active commuting, body fat, and body mass index

- Cross-sectional, ~16 000 participants

- BMI & Body Fat % analysed

- Three categories of commuting

1. Private

2. Public

3. Active

Public:

BMI = 1.10 lower (95% CI, 0.53-1.67)

BF% = 2.42 lower (95% CI, 1.23-3.60)

Active:

BMI = 0.97 lower (95% CI, 0.36-0.87)

BF% = 2.22 lower ( 95% CI,1.14-3.30)

Results

- - - - - - - - -

Public:

BMI = 0.72 lower (95% CI, 0.53-1.67)

BF% = 1.97 lower (95% CI, 0.87-3.08)

Active:

BMI = 0.87 lower (95% CI, 0.36-0.87)

BF% = 1.39 lower (95% CI, 0.56-2.22)

PT + AT

Complementary!

- Association between PT and AT examined with respect to MVPA and steps per day.

- Active transport for >10min = higher odds of meeting MVPA.

- Men : 2.01 OR (95C%CI, 1.58-2.54)

- Women: 1.57 OR (95%CI, 1.25-1.96)

BUT

- Greater association when PT + AT

- Men: 2.98 OR (95% CI, 2.31-3.91)

- Women: 1.82 OR (95%CI, 1.45-2.29)

PT & Social Isolation

- Transportation is a key factor in isolation!

- Older adults , PWDs face unique risks regarding isolation and loneliness.

- 2018 Transportation Needs and Assessment by National Ageing and Disability Transportation Center

HOW?

Isolation KILLS

- Actual & perceived social isolation both associated with increased risk for early mortality

- Social isolation : avg 29% increased, OR = 1.29

- Loneliness: avg 26% increased, OR = 1.26

- Living alone: avg 32% increased, OR = 1.32

- No significant differences across gender, region, length of follow-up.

- Social deficits more predictive of death in samples with an avg age < 65 years

Isolation & Mortality

How can we be better?

IMPROVE

pteg (UK): 4As

1. Affordability

2. Availability

3. Accessibility

4. Acceptability

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