Changes in active commuting and changes in health

BACKGROUND: Previous studies have shown that regular physical activity through active commuting, such as walking or cycling, is positively associated with physical and mental health. However, because longitudinal within-individual studies on the association between active commuting and health are scarce, the results may have been biased due to unmeasured confounding. Additionally, information about commute length has rarely been included in studies on within-individual change in active commuting. A better understanding of the association between active commuting and health could inform public health policies and interventions to promote active transportation. METHODS: Using two waves (2020, T1 and 2022, T2) of self-report data from of the Finnish Public Sector study (N = 16881), we examined the association between within-individual changes in active commuting and health. Active commuting was measured by kilometers/week (i.e., by multiplying the number of walking or cycling days/week with the daily commute distance). The primary outcome, self-rated health, was measured with a single item (scale from 1=poor to 5=good) at T1 and T2. The secondary outcomes, psychological distress and sleep problems were measured only at T2 and were therefore analyzed with a between-individual model. RESULTS: After adjustment for potential time-varying confounders such as socioeconomic factors, BMI, and health behaviors, an increase of 10 additional active commuting kilometers per week was associated with a slight improvement in self-rated health (unstandardized B = 0.01, p = 0.001). No associations were observed between changes in active commuting and psychological distress or sleep problems. CONCLUSIONS: This study provides evidence supporting a modest causal association between active commuting and improved health. Promoting walking or cycling to work may have potential benefits for public health, but further intervention research is needed to better understand the extent of these benefits. KEY MESSAGES: • The study provides evidence supporting a modest causal association between active commuting and improved self-rated health. • Promoting walking or cycling to work may have potential benefits for public health.