Understanding how accessibility influences health via active travel: Results from a structural equation model

Active travel (walking and cycling) is increasingly being recognised as a potentially effective means of increasing physical activity levels and thereby contribute to physical and mental health. Research related to active travel typically either focuses on the determinants of active travel or its health effects. As far as the authors are aware, no studies have tried to include both sets of variables in a single empirical model. The goal of this study is to address this gap by developing and estimating a structural equation model including both spatial determinants of active travel and relevant physical and mental health outcomes. The model is estimated using aggregated data from all Dutch municipalities, 355 in total. The results indicate that the walking and cycling modal shares are consistently negatively associated with the prevalence of obesity and diabetes and positively correlated with overall physical activity. The effects are similar in size as those of sport participation. The results provide insights as to which spatial characteristics municipalities should focus on if their aim is to increase public health via active travel.