13 Links between children’s independent mobility, active transport, physical activity and obesity

Summary and recommendations for practice



  • Internationally, the past 40 years have seen a number of inter-related trends in developed Anglo-American countries, including radically declining levels of children’s independent mobility (CIM), increased parental use of cars to transport children to school and play, decreasing everyday physical activity of both children and adults, and increasing child obesity rates.
  • The level of children’s everyday physical activity is influenced by gender, household income, parental and societal fears, the physical design of neighborhoods, and broader social policies that discourage “risk”.
  • Several promising practices can have an impact on improving children’s active transport, everyday physical activity and autonomy:
  • traffic calming, lowering speed limits, improving access to destinations, and other physical environment modifications
  • social planning and marketing interventions, including school travel plans and walking school bus schemes
  • rights-based participatory planning approaches such as Child Friendly Cities projects.

Introduction


Children’s independent mobility means the freedom of those under 18 years to move around in public spaces without adult accompaniment.1 The phrases “battery reared” and “free range” refer to two diametrically opposed approaches to children’s upbringing.2,3 “Free range” children have traditionally been allowed, and indeed expected, to walk, cycle, or take public transport on their own for everyday trips between home, school, parks, shops and friends’ houses. They have also been allowed, in previous generations, to independently explore their immediate neighborhood and the broader city with increasing confidence as they mature. Internationally, the past 40 years have seen a number of inter-related trends: radically declining levels of CIM, increased parental use of cars to transport children to school and play, decreasing everyday physical activity of both children and adults, and increasing child obesity rates.


There is a relatively small and recent interdisciplinary research on children’s independent mobility, primarily reflecting the disciplines of transportation planning, social geography, environmental psychology and public health. The purpose of this chapter is to explore the links between these various phenomena, to detail the complex factors behind these trends, and to examine policy changes that show promise in addressing these interrelated problems. It draws on research published in English, most of which has been conducted in Western Europe, North America and Australasia. Research websites (e.g., Active Living Research, health-evidence.ca, UNESCO Child Friendly Cities) were searched for additional literature regarding promising policies and practices.


Battery-reared children: the extent of the problem


Most research on levels of CIM focuses on the journey to school, for two reasons. First, the majority of children must enact a journey to and from school each weekday. Second, the journey to and from school has often been a springboard for children to exercise their initial acts of independent mobility.


Studies in several developed countries show a radical shift from children walking to school on their own in the 1970s, to children being driven, mostly by parents, in the 1990s and 2000s. For instance, Hillman et al1 found that in 1971, 80% of 7–8-year-olds in the UK were allowed to travel to school on their own, but in 1990, this had fallen to 9%. In Perth, Western Australia, the percentage of children walking or cycling to school fell from 66% in 1974 to 9% in 2005.4 Successive UK National Travel Surveys show car trips taken by children aged 5–16 have increased 37% from 1985/86 to 1997/99, with a corresponding decrease of 31% in the number of trips walked by children.5


The radical reduction of CIM increases children’s reliance on adults and their health risks, and establishes a car-addicted lifestyle that may continue to adulthood.4 Children who are dependent upon vehicular transport may miss out on the incidental accumulation of physical activity that walking and cycling, as well as hopping, climbing and exploring, provide.6,7 Although debates persist about whether the journey to school constitutes the most important source of physical activity for most children, it can be a part of a daily physical routine that can increase activity levels.8 For example, regular walking to and from school was associated with greater energy expenditure than school organized physical education.9


There are also mental health impacts from adult dependent mobility. Opportunities for talking with friends and neighbors are reduced when children are transported via automobiles, with implications for social connectedness and community well-being.10 Childhood experiences may determine adult behaviors. Walking, cycling and public transport may not even be considered as possible forms of transport when children become accustomed to being driven.11–13 When Malone14 asked 50 children aged 4 to 8 in the regional Victorian city of Bendigo to take photographs of their typical week, over half included a picture of the back seat of the family car. In Perth Australia, children living in low-density suburbs were found to travel predominantly by car for all trip purposes in 2006. For those aged less than 10, 80% of all trips were by car. While there was a reduction in car trips to around 55% of total journeys in the adolescent years 10 to 17, once they obtained drivers’ licences 80% of trip-making reverted to car journeys.15


The confinement of children: possible causes


The most commonly cited reason for declining children’s independent mobility is child and parental fears of traffic safety and stranger danger (the latter connoting children getting abducted or molested). A recent Australian survey found that 80% of children aged 10–12 and 84% of children aged 5–6 said they were concerned about road safety, with even higher self-reported fears about stranger danger.16 Fear of cars and strangers were also the two most common reasons given for limiting children’s independent mobility in a large-scale study of parents in Italy,17 and in the UK.1 Such fears can be provoked by media coverage of relatively rare incidents.2


In addition to the perception of fear, there is a growing pressure to be a “good” parent, protecting children from all potential risks while providing them with the best opportunities.18–20 Social interactions between parents play an important part in establishing local norms about children’s trips to school, with peer pressure that all parents should drive their children to school.21 Conversely, those parents engaged in practices out of line with the local norm claim that they are stigmatized and marginalized by other parents.22


The chauffeur role of parents is reinforced when they drive their children to school, based on the convenience of dropping off their children on the way to work, in what transport researchers call trip-chaining behaviour. The location of a parent’s workplace has a strong bearing on whether or not a child’s school journey will be taken on foot.19,23,24 Journeys to school are “bound up with other activities and this affects both the nature of the journey and mode of transport used”.25


Some of the factors influencing parental choices to limit children’s active and independent travel are intrinsic to the particular community, while others are related to the culture of the broader society. Some countries such as Germany and Japan have an ethos of collective responsibility for looking out for children, and also have large numbers of people of all ages using outdoor public space, owing to built environment and socio-cultural factors. This contrasts with more individualistic societies such as the USA, UK, Australia and New Zealand, which have lower levels of children’s independent mobility.1,11,14


Socio-economic status (SES), both of families and of areas, is another factor, although the evidence is somewhat contradictory. Timperio et al26 found that children from lower SES areas were less likely to be physically active than children from high SES areas, even though low SES households are less likely to own vehicles. Another Australian study found that a higher proportion of children living in low SES areas reported being able to travel to more destinations over larger distances than those living in high SES areas.27 In their study of four neighborhoods in Christchurch, New Zealand, Tranter and Pawson11 found that traffic levels were greater determinants of active transport than household income.


In addition to parental regulations and socio-economic status, children’s active transport is contingent upon the physical planning and design features of their neighborhoods. Studies of the environmental attributes of particular areas in relation to children’s mobility have found that key factors include the age, density, and proximity of the neighborhood to the central city (with older, denser neighborhoods tending to encourage independent mobility); a set of traffic danger signifiers including amount of traffic, width of roadway, presence or absence of footpaths, dangerous crossings and lots of cars parked on the street; and a set of stranger danger signifiers, including visible signs of incivilities and alcohol/drug use (dog mess, broken bottles, used drug paraphernalia); and local air and noise pollution.17


Promising policies and practices


Several studies have shown that children prefer active transport over driving to destinations. A UK survey of 800 children aged 7 to 11 found that 38% of children who are at present driven to school would prefer to walk or cycle.28 In Melbourne, where 72% of children are driven to school, 61% say that they would prefer to walk, given the choice.29 Many children also prefer independent over dependent travel. A recent study of Sydney primary school pupils found that while 70% from the inner city and 80% from the outer suburb traveled with a parent or guardian to school, 33% of inner-city children and 44% of outer-suburb children would prefer to walk to school with a friend or sibling, with 24% of inner-city children and 14% of outer-suburb children preferring to walk alone.7


Given children’s preferences, and the negative physical and mental health consequences of adult dependent mobility, there are surprisingly few policies or programs in the English-speaking developed countries most affected to address these interrelated issues. More recently, researchers have begun to address the interaction between environmental, interpersonal and social barriers and enablers. For instance, Timperio et al16 studied 235 children aged 5 to 6 years and 677 children aged 10 to 12 years, and found that parental perceptions of few other children walking in the neighborhood and no safe road crossings were negatively correlated with walking or cycling to school, while for children, distance and (for younger children) steep inclines were negatively correlated with wanting to walk or cycle to school. Creating supportive environments for children’s independent mobility and physical activity thus requires overcoming both social and built environment barriers at the neighborhood level, as well as creating opportunities to listen to the children themselves.


Modifying the built environment


Built environment modifications (e.g., traffic calming and home zones) seek to promote the safe passage and increased visibility of child pedestrians. Traffic-calming measures endeavor to reduce the negative effects of vehicles, alter driver behavior, and enhance overall conditions for pedestrians. Posted travel speed, street alignments, vehicular obstacles and other design tactics act to lower travel speeds. In some cases, streets are closed off to through traffic, particularly in residential areas.17,30–33


Traffic calming measures have been shown to be successful in a number of countries. For instance, up until the 1970s, Denmark had the highest rate of child road deaths in western Europe. In 1976, the Danish national government passed legislation requiring local authorities to reduce the speed on roads to a norm of 30 km/h and to invest in greater walking and cycling infrastructure. Today, Denmark has much higher levels of walking and cycling than the UK and much lower casualty rates.34 In the UK, where introduction of 30 km/h zones has met with much more limited acceptance by local traffic engineers, the zones have proved successful in terms of speed reduction, accident rates and increased resident perceptions of safety, although traffic calming and enforcement are still necessary in these areas.32


The UK Home Zone projects, introduced in 1999, usually involve a shared surface for cars and pedestrians (no grade or other separation of roadway and footpath), tree planting, improved lighting, use of colored and textured surface treatments, and sometimes other design aspects such as a symbolic “gateway” entrance to the street.35 Possible benefits of Home Zones, apart from reducing road traffic accidents, include engendering greater social interaction and a sense of symbolic ownership, reducing the fear of crime, and providing places for children’s informal recreation close to home. They are the opposite of the more traditional “Radburn” approach to transportation planning, which stressed complete separation of vehicle and pedestrian pathways, since the isolated subways and footbridges that resulted from the Radburn approach were widely perceived as being unsafe in terms of stranger danger,36 and remained unpopular for walking.35


An evaluation of seven home zones indicated the development of stronger communities in all sites as a result of their establishment. Adult residents reported knowing more neighbors afterwards, and an increased ability to resolve neighborhood disputes through discussion rather than bringing in the authorities.33 Lower speeds and reduced traffic resulted at all sites, and in five sites there were measurable increases in CIM. However, implementation has been slow and some researchers contend that traffic speeds may need to be as low as 12 km/h to encourage greater child pedestrian use.33


New research between planning, transport and health is also articulating the importance of accommodating children’s incidental physical activity through accessible facilities and interesting environments. Approximately 150 children aged 10 in three Melbourne schools were asked to map and photograph neighborhood attractions that they could walk or cycle to. Common destinations included playgrounds and sports fields as well as less elaborate recreational possibilities such as a target painted on a wall for ball playing.37 Other studies provide encouraging evidence of associations between children’s activity levels and the proximity of parks.38–40 Gill33 suggests that amenities such as children’s mosaics and other public art may increase symbolic control of streets (see Engwicht),41 while Prezza et al17 suggest that greenery in road dividers and along streets may mitigate immediate air pollution, reduce traffic noise and create a degree of amenity. Unlike the evaluation literature on traffic calming, no studies have been located to either prove or disprove that policies aimed at increasing the number and types of neighborhood amenities increase children’s autonomous and active movement.


Finally, a set of larger-scale built environment interventions, including “smart growth” and “new urbanism” projects, have developed “a persuasive hypothesis attributing the change in travel behaviour … to the urban form of our communities”.42 Yet the evidentiary support for built environment changes influencing children’s (as opposed to adult’s) travel behaviour is not well advanced.


Social planning and marketing: school travel plans and the walking school bus


In contrast to the built environment emphasis on the community level, much public health literature is focused on individual level social determinants of children’s modal choice, such as self-confidence in one’s abilities (known as “self-efficacy”), time, interest, perceived health and encouraging parents to allow their children to walk or cycle.42


A number of policies and programs combining built environment changes with social marketing have been implemented, particularly in relation to the journey to school. Safe Routes to School programs were pioneered in Denmark in the 1980s as part of the national road safety initiative described above.42 The program has been adopted in several different countries, including the USA,42 the UK,43 and Australia.44 According to McMillan,42 Safe Routes to School involve “3Es”:


1. education of both children and drivers on road safety


2. enforcement of traffic laws around schools


3. engineering of the street environment along the routes to school.


Evaluations of School Travel Plans have found mixed results. Evaluations in the UK show that schools were successful in producing plans, but unsuccessful in changing travel behavior, which was generally due to the long-term commitment necessary from both the school and parents.26 An intensive US School Travel Plan initiative that included walk/bike to school days, a “frequent rider miles” competition, classroom education, walking school buses and bike trains resulted in a 64% increase in walking, a 114% increase in cycling, and a 91% increase in car-pooling to the school, along with a 29% reduction in driving alone after two years.45 However, there was no comparison with a control group, changes in independent mobility were not tested, and a limited number of the same children were tested both before and after the changes. A more general criticism is that while school travel plans involving extensive activities over a number of years can be successful, children’s needs go well beyond traveling in the same way to a fixed destination repeatedly, and attempts to restrict children to “safe” routes and designated play areas may be both socially undesirable and impractical.32


There is a similar controversy related to another school-based program, the walking school bus (WSB). The idea was for walking bus drivers, who would “walk a set route, much like a school bus, collecting children along the route and delivering them safely to school”.30 The idea rapidly diffused through at least five countries—Canada, the UK, the USA, Australia and New Zealand—to the point where thousands of local initiatives have been established in the past 10 years.5,9,46 Along the way, the informal basis of the idea has been lost. Engwicht, who in 2003 unequivocally stated that “in many cases, WSB has outlived its usefulness and in some circumstances has become counterproductive”, gives an example of over 100 volunteers showing interest in one program in his home town of Brisbane; but by the time compulsory training and exhaustive background checks had been completed, only three potential volunteers were left.47


Mackett et al,48 in the UK, found that children are twice as likely to report positive social aspects of WSB initiatives than parents, although both report greater friendships with neighbors as a result of these programs. Yet evaluations indicate no decrease in local car traffic. Parents may walk their children to school and then return to drive their car.43 School teachers report mixed results in lessening car congestion near school entrances as a result of WSB, and also a loss of parent volunteers over time, particularly since child interest in WSB declines in senior primary grades.9


An evaluation of WSB schemes in New Zealand suggests that WSB may result in increased physical activity, but actually reinforces adult-dependent mobility, since it relies on adult supervision and adult-imposed rules on group travel that is inimical to independent exploration.46 However, children and adults are both highly articulate on the benefits, reporting enjoying talking as they walk, meeting neighbors, and enjoying the daily exercise.46 A criticism of the Auckland, New Zealand WSB initiative is the prevalence of WSB in higher SES areas, while child pedestrian injuries are more likely to occur in low SES areas.49 Another New Zealand study agreed that parents report new and better friendships and acquaintances, leading to other get-togethers on the street.5 Kingham and Ussher5 also suggested that the WSBs may increase independent mobility. Children say that they want to walk to other places as a result of improved fitness and knowing their neighborhood better, and children do “graduate” from WSB,9 presumably to independent walking, at the age of 9 or 10.5


A rights-based approach: Child-Friendly Cities and participatory planning


Child-Friendly Cities (CFC s) is a UNICEF-sponsored program that aims to improve local governance capacity to support children’s rights, among them the right to “participate freely and fully in city life”, including walking safely on the street.50–52 The UN Convention on the Rights of the Child, adopted by all member states in 2000, includes “the child’s right to live in a safe, clear, and healthy environment and to engage in free play, leisure and recreation in the environment”.50 It sees children as “the future contributors, decision makers, and citizens of the world”, and children’s well-being and quality of life as prime indicators of a healthy environment, good governance and sustainable development.50


There are a plethora of child assemblies, consultation processes with children and youth, and child-empowering activities taking place, including many that are directly related to active transport and independent mobility. Dozens of European and Latin American cities have child assemblies where children regularly co-plan developments.53,54 In the USA, there is a Community-Based Education Resource (CUBE) manual on child-oriented communities: the Dutch Institute of Design has published design guidelines for children, and the Canadian Institute of Planners has A Kid’s Guide to Building Great Communities.55 However, the Child Friendly Cities commitment from local governments is often limited to vision and consultation rather than implementation, and a review of the Child Friendly Cities database has found very limited information on outcomes arising from projects.53


Despite such limitations, the Italian projects, in particular, have led to substantial changes in both the physical and the social environment. In Fano, the Children’s City project combines letting children plan urban renewal through creative laboratories, children’s councils that entrench participatory planning practices, and initiatives to encourage autonomy. Certain streets have been closed to traffic, access to sports installations and equipment has been improved, and there has been increased redevelopment of public squares and semi-public areas within condominium areas as play spaces. In Pistoia, the project “Safe Routes round the school C. Collodi” has led to increases in children walking to the school by themselves since its inception in 2000, although exact figures are not provided, and children have also reclaimed a square near the school that was previously used as a car park.52 Identifying the concerns and/or neighborhood improvements important to children may increase their interests in using such spaces actively and autonomously.


Conclusion


There is a clear interrelationship between declines in CIM, reduced everyday physical activity and increased obesity rates. However, the evidence base on what might work to increase children’s independent mobility is still poor, partly because it is still not recognized as a policy priority, and partly because the mechanisms to include children in evaluating and changing their urban environments are so poor. Traffic calming is promising at the very local level of the individual street, but does not appear to address underlying parental concerns about CIM, or to expand children’s home territory much beyond the immediate vicinity of the home. The evidence base on School Travel Plans and walking school bus is mixed in terms of success, and again, focuses on a set of specific routes to one place (the school) rather than the entire community. A more holistic emphasis on children’s participation in planning, encompassing both physical design and social change, is evident in Child Friendly Cities, but there is, at present, limited evidence that this approach works to change environments, let alone change behaviors or lead to resultant improvements in health and well-being. More holistic research is needed on how children actually travel: their needs, desires, and the built and social environment factors that may work to make children free to explore their local communities and lead healthier active lives.


Acknowledgement


The authors would like to acknowledge the financial support of the Australasian Centre for the Governance and Management of Urban Transport (GAMUT).


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Aug 4, 2016 | Posted by in PEDIATRICS | Comments Off on 13 Links between children’s independent mobility, active transport, physical activity and obesity

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