Public transit and depression among older adults: using agent-based models to examine plausible impacts of a free bus policy.

ACCESS TO HEALTH CARE AGEING CHILD HEALTH CHRONIC DI DIET ENVIRONMENTAL HEALTH EPIDEMIOLOGY EXERCISE Epidemiological methods Epidemiology of ageing GEOGRAPHY HEALTH POLICY Health inequalities INEQUALITIES MENTAL HEALTH METHODOLOGY Neighbourhood/place POLICY PSYCHOSOCIAL FACTORS PUBLIC HEALTH POLICY SOCIAL EPIDEMIOLOGY SOCIAL SCIENCE

Journal

Journal of epidemiology and community health
ISSN: 1470-2738
Titre abrégé: J Epidemiol Community Health
Pays: England
ID NLM: 7909766

Informations de publication

Date de publication:
11 2020
Historique:
received: 07 10 2019
revised: 15 04 2020
accepted: 12 05 2020
pubmed: 15 6 2020
medline: 3 9 2021
entrez: 15 6 2020
Statut: ppublish

Résumé

Daily transport is associated with mental health. A free bus policy (FBP) may be effective in promoting the use of public transit in older adults and be associated with reductions in depressive symptoms. We developed an agent-based model and grounded it using empirical data from England to examine the impact of an FBP on public transit use and depression among older adults. We also used the model to explore whether the impact of the FBP bus use and depression is modified by the type of income segregation or by simultaneous efforts to improve attitudes towards the bus, to reduce waiting times or to increase the cost of driving via parking fees or fuel price. Our model suggests that improving attitudes towards the bus (eg, campaigns that promote bus use) could enhance the effect of the FBP, especially for those in proximity to public transit. Reducing wait times could also significantly magnify FPB impacts, especially in those who live in proximity to public transit. Contrary to expectation, neither fuel costs nor parking fees significantly enhanced the impact of the FBP. The impact of improving attitudes towards the bus and increasing bus frequency was more pronounced in the lower-income groups in an income segregation scenario in which destination and public transit are denser in the city centre. Our results suggest that the beneficial mental health effects of an FBP for older adults can be magnified when combined with initiatives that reduce bus waiting times and increased spatial access to transit.

Sections du résumé

BACKGROUND
Daily transport is associated with mental health. A free bus policy (FBP) may be effective in promoting the use of public transit in older adults and be associated with reductions in depressive symptoms.
METHODS
We developed an agent-based model and grounded it using empirical data from England to examine the impact of an FBP on public transit use and depression among older adults. We also used the model to explore whether the impact of the FBP bus use and depression is modified by the type of income segregation or by simultaneous efforts to improve attitudes towards the bus, to reduce waiting times or to increase the cost of driving via parking fees or fuel price.
RESULTS
Our model suggests that improving attitudes towards the bus (eg, campaigns that promote bus use) could enhance the effect of the FBP, especially for those in proximity to public transit. Reducing wait times could also significantly magnify FPB impacts, especially in those who live in proximity to public transit. Contrary to expectation, neither fuel costs nor parking fees significantly enhanced the impact of the FBP. The impact of improving attitudes towards the bus and increasing bus frequency was more pronounced in the lower-income groups in an income segregation scenario in which destination and public transit are denser in the city centre.
CONCLUSION
Our results suggest that the beneficial mental health effects of an FBP for older adults can be magnified when combined with initiatives that reduce bus waiting times and increased spatial access to transit.

Identifiants

pubmed: 32535549
pii: jech-2019-213317
doi: 10.1136/jech-2019-213317
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

875-881

Informations de copyright

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Yong Yang (Y)

School of Public Health, University of Memphis, Memphis, Tennessee, USA Yyang15@memphis.edu.

Brent A Langellier (BA)

Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA.

Ivana Stankov (I)

Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA.

Jonathan Purtle (J)

Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA.

Katherine L Nelson (KL)

Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA.

Erica Reinhard (E)

Department of Global Health and Social Medicine, School of Global Affairs, King's College London, London, UK.

Frank J Van Lenthe (FJ)

Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands.

Ana V Diez Roux (AV)

Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA.

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