{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:12:27Z","timestamp":1772169147339,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/wellcomeopenres.19147.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T00:00:00Z","timestamp":1722816000000}}],"reference-count":36,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T00:00:00Z","timestamp":1722816000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011089","name":"University of Wisconsin Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011089","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","award":["209387"],"award-info":[{"award-number":["209387"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]},{"name":"John P Holton Endowed Chair of Health and the Environment, University of Wisconsin-Madison"}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns5:p>Background The prevalence of chronic disease in the US adult population varies across socioeconomic groups in the USA where approximately six in 10 adults have a chronic condition. Walking or cycling reduces the risk to many of these diseases and is influenced by the built environment, accessibility, and safety. Methods We performed multivariate logistic and linear regression on the Health-Oriented Transportation model parameters using the 2009 and 2017 US National Household Transportation surveys, restricted to adults in major metropolitan areas. Model covariates included socioeconomic and environmental characteristics. Results Using odds ratios (OR) adjusted for model covariates, we observe several significant variables in 2009 and 2017. Residents of households with no cars were more likely to walk or cycle than those with two cars; OR=5.4 (4.8, 6.0). Residents of households in a census block with population density greater than 2,5000 persons\/square mile were more likely to walk or cycle than those with a population density of 2000\u20133999; OR=2.6 (2.3, 2.8). Individuals with a graduate or professional degree were more likely to walk or cycle than those with a high school degree; OR=2.1 (1.9, 2.2). Individuals that self-report as Black or African American, or Asian are less likely to walk or cycle than White; OR=0.60 (0.56, 0.66), OR=0.70 (0.65, 0.75). The proportional increase in all-cause mortality from estimated reductions in physical activity for African American, Asian, and Hispanic populations were 1.0%, 0.7%, 0.8%, respectively. Conclusions Access to automobiles and the surrounding population density are primary factors in the decision to walk or cycle. After adjusting for these and other factors, members of low-income, low-education, Black or African American, and Asian populations in US metropolitan areas are less likely to walk or cycle than high-income, high-education, or White populations and the discrepancy in physical activity is likely to contribute to health inequity.<\/ns5:p>","DOI":"10.12688\/wellcomeopenres.19147.2","type":"journal-article","created":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T11:45:42Z","timestamp":1722858342000},"page":"266","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["The influence of socioeconomic characteristics on active travel in US metropolitan areas and the contribution to health inequity"],"prefix":"10.12688","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9424-656X","authenticated-orcid":false,"given":"Samuel","family":"Younkin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8589-1671","authenticated-orcid":false,"given":"Henry","family":"Fremont","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Bratburd","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daritza","family":"De Los Santos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7131-9698","authenticated-orcid":false,"given":"Jonathan","family":"Patz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2024,8,5]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","DOI":"10.15620\/cdc:112079","article-title":"Mortality in the United States, 2020 - Data Brief #427.","volume":"427","year":"2021"},{"key":"ref-2","article-title":"Racial and ethnic health inequities and medicare - health status and disease prevalence.","author":"N Ochieng","year":"2021"},{"key":"ref-3","doi-asserted-by":"publisher","first-page":"1083-1092","DOI":"10.1016\/j.amjmed.2022.04.010","article-title":"Temporal trends in racial and ethnic disparities in multimorbidity prevalence in the United States, 1999-2018.","volume":"135","author":"C 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To address this we have made the following change to line 26. &quot;Our analysis is the first to restrict the sample to major metropolitan areas, and one of the few to use regression models with social and environmental covariates.&quot; was changed to &quot;Our analysis, performed using regression models that include social and environmental covariates, is the first to restrict the sample to major metropolitan areas.&quot;  Thank you for bringing attention to the choice for the distribution of background physical activity. The end of the second paragraph in the Limitations section states, &quot;Since it is unknown how this distribution varies across the social and environmental variables considered here, we assume that the distribution of physical activity is the same in all subpopulations.&quot; This is not precisely correct. The crux of the problem is that our comparison is between the distribution of physical activity in the reference population and the same distribution shifted by the change in travel activity that results from changing one variable in the regression models. The primary limitation is that the methodology is not symmetric with respect to choice of reference population and the distribution chosen to represent the reference population cannot be specified precisely. For consistency with our choice for the exposure-response function we use the sample statistics from Arem et al. to approximate the baseline distribution. To address this we replaced paragraph 2 of the Limitations subsection. &quot;To arrive at estimates of the health impacts we must make assumptions regarding the underlying distribution of overall physical activity. If the underlying distribution of physical activity is already high in a population, changes to travel activity will have less of an effect. Since it is unknown how this distribution varies across the social and environmental variables considered here, we assume that the distribution of physical activity is the same in all subpopulations.&quot; has been changed to &quot;To make estimates about the effect of model variables on all-cause mortality we must use a hypothetical reference population, assume a distribution of physical activity for that population, and compare that against the distribution found by adding the change in physical activity due to active travel estimated from the regression coefficients described above. The necessity of specifying the baseline distribution is indeed a limitation for physical activity is known to vary across demographic variables such as race and sex 37. It is important to remember that the results presented here must be viewed as the influence a given model variable has on a hypothetical population in which the distribution of physical activity is that of the sample in the study by Arem et al.18&quot; where the citation 37 is for Saffer et al. (2013).  We agree with the reviewer that including trips with the purpose of &quot;Go to gym\/exercise\/play sports&quot; improves the analysis. Line 42 of WOR-1-2009.Rmd and line 41 of WOR-1-2017.Rmd were edited so that no trips are excluded based on the WHYTO variable. The statement on lines 82-85: &quot;Trips in the 2017 survey with the stated purpose Exercise (go for a jog, walk, walk the dog, go to the gym), and trips in the 2009 survey with the purpose Go to gym\/exercise\/play sports were removed from the analysis (3.4% and 3.9% of all trips, respectively) since unrelated to travel.&quot; was removed from text. All figures, tables, and results were updated after re-running analysis. We agree with the reviewer that the HOT model needed a more fuller description. We have replaced lines 132-140: &quot;The HOT model uses the distribution of leisure time physical activity from Arem et al. (2015) and compares it to the distribution found by adding (or subtracting) the difference in travel activity between two populations 17 . These two distributions, along with an exposure-response function for all-cause mortality also estimated from Arem et al., make up a comparative risk assessment which allows the estimation of the population attributable fraction 17 . The HOT model assumes that travel activity is distributed as a mixture of a log-normal distribution and a point-mass at zero and that all new travel activity is additional physical activity with no substitution from other domains.&quot; with a more lengthy description of the HOT model. See revised manuscript for text. (Note that the equations and length of the fuller description make it difficult to post here.)  Thank you for the comment regarding results that differed from prior studies. We have provided more detail through an update of the Discussion section as follows: - First sentence of Paragraph 2 &nbsp; - we have changed &quot;is the first&quot; to &quot;is among the first.&quot;  Second sentence of Paragraph 2 &nbsp; - we have changed &quot;In contrast to this study, previous...&quot; to &quot;Previously...&quot;  Fourth sentence of Paragraph 2 &nbsp; - we have removed &quot;We chose to restrict the population to major metropolitan areas to remove some of the confounding between the race and walking relationship due to urbanicity and population density.&quot;  Paragraph 3 &nbsp; - Inserted at the end: &quot;Our results differed from the previously mentioned studies by Whitfield, Pucher, and Kruger because those studies neither included urban\/rural status nor subset the sample to include only residents of major metropolitan areas 12, 25, 26. Correlation between race and residence in rural areas, along with low rates of active travel in rural settings, confounds the relationship between active travel and race. To avoid this, we chose to subset the sample based on residence in a major metropolitan area. In a more recent study Buehler et al. did include urban\/rural status in their statistical analysis of walking and cycling in the U.S. and identified an increase in the odds ratio for both walking and cycling among the Non-Hispanic White population, relative to all other populations 36.&quot;  Note that a new reference to Buehler is included in the above paragraph.","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-266\/v2#referee-comment-5723","order":2,"name":"referee-comment-5723","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.25092.r95785, Jamie Furlong, Westminster University, London, England, 25 Sep 2024, version 2, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/8-266\/v2#referee-response-95785","order":3,"name":"referee-response-95785","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by Wellcome [209387, <a href=https:\/\/doi.org\/10.35802\/209387>https:\/\/doi.org\/10.35802\/209387<\/a>]; the University of Wisconsin Foundation; and the John P Holton Endowed Chair of Health and the Environment, University of Wisconsin-Madison. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}