Spatial and Temporal Trends in Travel for COVID-19 Vaccinations.

Introduction: Understanding spatial and temporal trends in travel for COVID-19 vaccinations by key demographic characteristics (i.e., gender, race, age) is important for ensuring equitable access to and increasing distribution efficiency of vaccines and other health services. The aim of this study is to examine trends in travel distance for COVID-19 vaccinations over the course of the vaccination rollout in North Carolina. Methods: Data were collected using electronic medical records of individuals who had first- or single-dose COVID-19 vaccination appointments through UNC Health between December 15, 2020, and August 31, 2021 (N = 204,718). Travel distances to appointments were calculated using the Euclidean distance from individuals' home ZIP code centroids to clinic addresses. Descriptive statistics and multivariable regression models with individuals' home ZIP codes incorporated as fixed effects were used to examine differences in travel distances by gender, race, and age. Results: Males and White individuals traveled significantly farther for vaccination appointments throughout the vaccination rollout. On average, females traveled 14. 4 miles, 3.5% shorter distances than males; Black individuals traveled 13.6 miles, 10.0% shorter distances than White individuals; and people aged 65 and older traveled 14.5 miles, 2.6% longer distances than younger people living in the same ZIP code. Conclusions: Controlling for socioeconomic status and spatial proximity to vaccination clinics at the ZIP code level, males and White individuals traveled longer distances for vaccination appointments, demonstrating more ability to travel for vaccinations. Results indicate a need to consider differential ability to travel to vaccinations by key demographic characteristics in COVID-19 vaccination programs and future mass health service delivery efforts.

Examining injury trends in parcel delivery drivers in the United States: Challenges and opportunities.

INTRODUCTION: Growth of e-commerce has caused a vast increase in parcel delivery, which raises concern for safety of drivers and other road users as more deliveries take place. METHODS: This project analyzes injury/illness and fatality trends among workers with delivery-related NAICS codes using three major sources of occupational hazard data in the United States: the Survey of Occupational Illnesses and Injuries, the Census of Fatal Occupational Injuries, and the Industrial Tracking Application. Descriptive statistics were employed to illustrate trends over time as well as to highlight opportunities for improved data collection and dissemination. RESULTS: The number of injuries to drivers has risen sharply over the past decade. Some of this increase appears due to growth of this industry, but increasing overall rates suggest the industry is becoming more hazardous. While nonfatal injuries were typically caused by continuous workplace exposures (e.g., repetitive strain, contact with object/equipment), fatalities were almost exclusively caused by transportation incidents. Additionally, crucial aspects of these trends are difficult or impossible to analyze given the current data landscape. CONCLUSIONS: Observed trends reinforce earlier calls for additional scrutiny of working conditions that threaten drivers. Injuries caused by transportation incidents are likely more severe than others and highlight the danger the transportation system poses to drivers and others. Current data collection and dissemination processes offer room to improve in terms of understanding how to prevent future injuries.

Systematic Review of Active Travel to School Surveillance in the United States and Canada.

Active travel to school is one way youths can incorporate physical activity into their daily schedule. It is unclear the extent to which active travel to school is systematically monitored at local, state, or national levels. To determine the scope of active travel to school surveillance in the US and Canada and catalog the types of measures captured, we conducted a systematic review of peer-reviewed literature documenting active travel to school surveillance published from 2004 to February 2018. A study was included if it addressed children's school travel mode across two or more time periods in the US or Canada. Criteria were applied to determine whether a data source was considered an active travel to school surveillance system. We identified 15 unique data sources; 4 of these met our surveillance system criteria. One system is conducted in the US, is nationally representative, and occurs every 5-8 years. Three are conducted in Canada, are limited geographically to regions and provinces, and are administered with greater frequency (e.g., 2-year cycles). School travel mode was the primary measure assessed, most commonly through parent report. None of the systems collected data on school policies or program supports related to active travel to school. We concluded that incorporating questions related to active travel to school behaviors into existing surveillance systems, as well as maintaining them over time, would enable more consistent monitoring. Concurrently capturing behavioral information along with related environmental, policy, and program supports may inform efforts to promote active travel to school.

Transportation barriers to care among frequent health care users during the COVID pandemic.

BACKGROUND: Transportation problems are known barriers to health care and can result in late arrivals and delayed or missed care. Groups already prone to greater social and economic disadvantage, including low-income individuals and people with chronic conditions, encounter more transportation barriers and experience greater negative health care consequences. Addressing transportation barriers is important not only for mitigating adverse health care outcomes among patients, but also for avoiding additional costs to the health care system. In this study, we investigate transportation barriers to accessing health care services during the COVID-19 pandemic among high-frequency health care users. METHODS: A web-based survey was administered to North Carolina residents aged 18 and older in the UNC Health system who were enrolled in Medicaid or Medicare and had at least six outpatient medical appointments in the past year. 323 complete responses were analyzed to investigate the prevalence of reporting transportation barriers that resulted in having arrived late to, delayed, or missed care, as well as relationships between demographic and other independent variables and transportation barriers. Qualitative analyses were performed on text response data to explain transportation barriers. RESULTS: Approximately 1 in 3 respondents experienced transportation barriers to health care between June 2020 and June 2021. Multivariate logistic regressions indicate individuals aged 18-64, people with disabilities, and people without a household vehicle were significantly more likely to encounter transportation barriers. Costs of traveling for medical appointments and a lack of driver or car availability emerged as major transportation barriers; however, respondents explained that barriers were often complex, involving circumstantial problems related to one's ability to access and pay for transportation as well as to personal health. CONCLUSIONS: To address transportation barriers, we recommend more coordination between transportation and health professionals and the implementation of programs that expand access to and improve patient awareness of health care mobility services. We also recommend transportation and health entities direct resources to address transportation barriers equitably, as barriers disproportionately burden younger adults under age 65 enrolled in public insurance programs.

Socio-economic disparities in activity-travel behavior adaptation during the COVID-19 pandemic in North Carolina.

The COVID-19 pandemic significantly affected human mobility. This study examines the changes in people's activity-travel behavior over 23 months (from Jan 2020 to Nov 2021) and how these changes are associated with the socio-economic status (SES) at the block group level in North Carolina. We identified 5 pandemic stages with different restriction regimes: the pre-pandemic, lockdown, reopening stage, restriction, and complete opening stage. Using the block-group mobility data from SafeGraph, we quantify visits to 8 types of destinations during the 5 stages. We construct regression models with interaction terms between SES and stages and find that visit patterns during the pandemic vary for different types of destinations and SES areas. Specifically, we show that visits to retail stores have a slight decrease for low and medium SES areas, and visits to retail stores and restaurants and bars bounced back immediately after the lockdown for all SES areas. The results suggest that people in low SES areas continued traveling during the pandemic. Transportation planners and policymakers should carefully design the transportation system to satisfy travel needs of those residents. Furthermore, the results also highlight the importance of designing mitigation policies that recognize the immediate recovery of visits to retail locations, restaurants, and bars.

Systematic Review of Active Travel to School Surveillance in the United States and Canada.

Active travel to school is one way youths can incorporate physical activity into their daily schedule. It is unclear the extent to which active travel to school is systematically monitored at local, state, or national levels. To determine the scope of active travel to school surveillance in the US and Canada and catalog the types of measures captured, we conducted a systematic review of peer-reviewed literature documenting active travel to school surveillance published from 2004 to February 2018. A study was included if it addressed children's school travel mode across two or more time periods in the US or Canada. Criteria were applied to determine whether a data source was considered an active travel to school surveillance system. We identified 15 unique data sources; 4 of these met our surveillance system criteria. One system is conducted in the US, is nationally representative, and occurs every 5-8 years. Three are conducted in Canada, are limited geographically to regions and provinces, and are administered with greater frequency (e.g., 2-year cycles). School travel mode was the primary measure assessed, most commonly through parent report. None of the systems collected data on school policies or program supports related to active travel to school. We concluded that incorporating questions related to active travel to school behaviors into existing surveillance systems, as well as maintaining them over time, would enable more consistent monitoring. Concurrently capturing behavioral information along with related environmental, policy, and program supports may inform efforts to promote active travel to school.

Innovative health care mobility services in the US.

BACKGROUND: Transportation barriers prevent millions of people from accessing health care each year. Health policy innovations such as shared savings payment models (commonly used in accountable care organizations) present financial incentives for providers to offer patient transportation to medical care. Meanwhile, ridesourcing companies like Uber and Lyft have entered the market to capture a significant share of spending on non-emergency health care transportation. Our research examines the current landscape of innovative health care mobility services in the US. METHODS: We conducted an environmental scan to identify case examples of utilization of ridesourcing technology to facilitate non-emergency health care transportation and developed a typology of innovative health care mobility services. The scan used a keyword-based search of news publications with inductive analysis. For each instance identified, we abstracted key information including: stakeholders, launch date, transportation provider, location/service area, payment/booking method, target population, level of service, and any documented outcomes. RESULTS: We discovered 53 cases of innovation and among them we identified three core types of innovation or collaboration. The first and most common type of innovation is when a health care provider leverages ridesourcing technology to book patient trips. This involves both established and nascent transportation companies tailoring the ridesourcing experience to the health care industry by adding HIPAA-compliance to the booking process. The second type of innovation involves an insurer or health plan formally partnering with a ridesourcing company to expand transportation offerings to beneficiaries or offer these services for the first time. The third type of innovation is when a paratransit provider partners with a ridesourcing company; these cases cite increased flexibility and reliability of ridesourcing services compared to traditional paratransit. CONCLUSIONS: Ridesourcing options are becoming a part of the mode choice set for patients through formal partnerships between ridesourcing companies, health care providers, insurers, and transit agencies. The on-demand nature of rides, booking flexibility, and integration of ride requests and payment options via electronic medical records appear to be the strongest drivers of this innovation.

Transportation Barriers to Health Care in the United States: Findings From the National Health Interview Survey, 1997-2017.

Objectives. To quantify the number of people in the US who delay medical care annually because of lack of available transportation and to examine the differential prevalence of this barrier for adults across sociodemographic characteristics and patient populations.Methods. We used data from the National Health Interview Survey (1997-2017) to examine this barrier over time and across groups. We used joinpoint regression analysis to identify significant changes in trends and multivariate analysis to examine correlates of this barrier for the year 2017.Results. In 2017, 5.8 million persons in the United States (1.8%) delayed medical care because they did not have transportation. The proportion reporting transportation barriers increased between 2003 and 2009 with no significant trends before or after this window within our study period. We found that Hispanic people, those living below the poverty threshold, Medicaid recipients, and people with a functional limitation had greater odds of reporting a transportation barrier after we controlled for other sociodemographic and health characteristics.Conclusions. Transportation barriers to health care have a disproportionate impact on individuals who are poor and who have chronic conditions. Our study documents a significant problem in access to health care during a time of rapidly changing transportation technology.

U.S. active school travel in 2017: Prevalence and correlates.

Active transportation to school (ATS), denoting walking and biking, is crucial to promote physical activity for youth. This study uses data from the 2017 National Household Travel Survey (NHTS) to report on the most recent and nationally representative school transportation patterns. Binary logit modeling determines significant factors associated with school travel mode choices. Spatial differences on school mode choices across the US are explored. In 2017 9.6% of the students of 5-17 years old usually walked and 1.1% biked to school. For students who usually walk to school, 77.5% of their school trips were less than one mile and, among usual bikers to school, 82.8% of trips were less than two miles. Student rates of walking to school decreased as the distance to school increased and biking rates peaked when distance to school was between 0.5 and 1 miles. When distance to school was <0.5 miles, walking was the most common mode for urban and rural regions. When the trip was shorter than or equal to one mile, factors such child's school grade, household vehicles per driver, and household income were associated with the decision to walk or bike to school. Other demographic characteristics like race and gender were not significantly related to ATS. While comparison across NHTS years should be viewed with caution due to changes in survey methodology, the decline of ATS rates indicate that more effective and higher reaching efforts for local, regional, and national interventions should be prioritized.

Impact of School Location on Children's Air Pollution Exposure.

The role of school location in children's air pollution exposure and ability to actively commute is a growing policy issue. Well-documented health impacts associated with near-roadway exposures have led school districts to consider school sites in cleaner air quality environments requiring school bus transportation. We analyze children's traffic-related air pollution exposure across an average Detroit school day to assess whether the benefits of reduced air pollution exposure at cleaner school sites are eroded by the need to transport students by bus or private vehicle. We simulated two school attendance scenarios using modeled hourly pollutant concentrations over the school day to understand how air pollution exposure may vary by school location and commute mode. We found that busing children from a high-traffic neighborhood to a school 19 km away in a low-traffic environment resulted in average daily exposures 2 to 3 times higher than children walking to a local school. Health benefits of siting schools away from high-volume roadways may be diminished by pollution exposure during bus commutes. School districts cannot simply select sites with low levels of air pollution, but must carefully analyze tradeoffs between location, transportation, and pollution exposure.

Automated Vehicles and Pedestrian Safety: Exploring the Promise and Limits of Pedestrian Detection.

INTRODUCTION: U.S. pedestrian fatalities have risen recently, even as vehicles are equipped with increasingly sophisticated safety and crash avoidance technology. Many experts expect that advances in automated vehicle technology will reduce pedestrian fatalities substantially through eliminating crashes caused by human error. This paper investigates automated vehicles' potential for reducing pedestrian fatalities by analyzing nearly 5,000 pedestrian fatalities recorded in 2015 in the Fatality Analysis Reporting System, virtually reconstructing them under a hypothetical scenario that replaces involved vehicles with automated versions equipped with state-of-the-art (as of December 2017) sensor technology. METHODS: This research involved the following activities: (1) establish functional ranges of state-of-the-art pedestrian sensor technologies, (2) use data from the Fatality Analysis Reporting System to identify pedestrian fatalities recorded in each state in the U.S. and District of Columbia in 2015, and (3) assess the maximum numbers of pedestrian fatalities that could have been avoided had involved vehicles been replaced with autonomous versions equipped with the described sensors. The research was conducted from July to December 2017. RESULTS: Sensors' abilities to detect pedestrians in advance of fatal collisions vary from <30% to >90% of fatalities. Combining sensor technologies offers the greatest potential for eliminating fatalities, but may be unrealistically expensive. Furthermore, whereas initial deployment of automated vehicles will likely be restricted to freeways and select urban areas, non-freeway streets and rural settings account for a substantial share of pedestrian fatalities. CONCLUSIONS: Although technologies are being developed for automated vehicles to successfully detect pedestrians in advance of most fatal collisions, the current costs and operating conditions of those technologies substantially decrease the potential for automated vehicles to radically reduce pedestrian fatalities in the short term.

Neighborhood Environment and Cognition in Older Adults: A Systematic Review.

CONTEXT: Some evidence suggests that treating vascular risk factors and performing mentally stimulating activities may delay cognitive impairment onset in older adults. Exposure to a complex neighborhood environment may be one mechanism to help delay cognitive decline. EVIDENCE ACQUISITION: PubMed, Web of Science, and ProQuest Dissertation and Theses Global database were systematically reviewed, identifying 25 studies published from February 1, 1989 to March 5, 2016 (data synthesized, May 3, 2015 to October 7, 2016). The review was restricted to quantitative studies focused on: (1) neighborhood social and built environment and cognition; and (2) community-dwelling adults aged ≥45 years. EVIDENCE SYNTHESIS: The majority of studies were cross-sectional, U.S.-based, and found at least one significant association. The diversity of measures and neighborhood definitions limited the synthesis of findings in many instances. Evidence was moderately strong for an association between neighborhood SES and cognition, and modest for associations between neighborhood demographics, design, and destination accessibility and cognition. Most studies examining effect modification found significant associations, with some evidence for effect modification of the neighborhood SES-cognition association by individual-level SES. No studies had low risk of bias and many tested multiple associations that increased the chance of a statistically significant finding. Considering the studies to date, the evidence for an association between neighborhood characteristics and cognition is modest. CONCLUSIONS: Future studies should include longitudinal measures of neighborhood characteristics and cognition; examine potential effect modifiers, such as sex and disability; and study mediators that may help elucidate the biological mechanisms linking neighborhood environment and cognition.

Trends in Automobile Travel, Motor Vehicle Fatalities, and Physical Activity: 2003-2015.

INTRODUCTION: Annual per-capita automobile travel declined by 600 miles from 2003 to 2014 with decreases greatest among young adults. This article tests whether the decline has been accompanied by public health co-benefits of increased physical activity and decreased motor vehicle fatalities. METHODS: Minutes of auto travel and physical activity derived from active travel, sports, and exercise were obtained from the American Time Use Survey. Fatalities were measured using the Fatality Analysis Reporting System. Longitudinal change was assessed for adults aged 20-59 years by age group and sex. Significance of changes was assessed by absolute differences and unadjusted and adjusted linear trends. Analyses were conducted in 2016. RESULTS: Daily auto travel decreased by 9.2 minutes from 2003 to 2014 for all ages (p<0.001) with the largest decrease among men aged 20-29 years (Δ= -21.7, p<0.001). No significant changes were observed in total minutes of physical activity. Motor vehicle occupant fatalities per 100,000 population showed significant declines for all ages (Δ=-5.8, p<0.001) with the largest for young men (Δ= -15.3, p<0.001). Fatalities per million minutes of auto travel showed only modest declines across age groups and, for men aged 20-29 years, varied from 10.9 (95% CI=10.0, 11.7) in 2003 to 9.7 (95% CI=8.7, 10.8) in 2014. CONCLUSIONS: Reduced motor vehicle fatalities are a public health co-benefit of decreased driving, especially for male millennials. Despite suggestions to the contrary, individuals did not switch from cars to active modes nor spend more time in sports and exercise. Maintenance of the safety benefits requires additional attention to road safety efforts, particularly as auto travel increases.

Association Between Neighborhood Social Environment and Children's Independent Mobility.

BACKGROUND: Independent travel among youth has diminished and rates of obesity have increased. It remains empirically unclear what factors influence the degree to which parents allow, or even enable, their children to be independently mobile. We analyze the association between parental perceptions of the social environment and the degree of independent mobility among children. METHODS: Surveys were conducted with 305 parents of 10- to 14-year-olds in the Bay Area during 2006 and 2007. The social environment was measured with scales assessing parental perceptions of child-centered social control, intergenerational closure, social cohesion, and safety from crime and traffic. Independent mobility was measured as a composite variable reflecting the degree to which a child is allowed to do the following without adult accompaniment: travel to neighborhood destinations, walk around the neighborhood, cross main roads, and ride transit. RESULTS: We find modest evidence of an association between parental perceptions of social cohesion and safety from traffic and independent mobility outcomes among children. Age is positively associated with increased independent mobility and Hispanic children experience greater restrictions on independent mobility. CONCLUSIONS: Interventions aimed at increasing physical activity among children through greater independent mobility should include neighborhood-level efforts to grow social cohesion and trust.

Longitudinal Analysis of Adolescent Girls' Activity Patterns: Understanding the Influence of the Transition to Licensure.

The proportion of teens and young adults with driver's licenses has declined sharply in many industrialized countries including the United States. Explanations for this decline have ranged from the introduction of graduated driver licensing programs to the increase in online social interaction. We used a longitudinal cohort study of teenage girls in San Diego and Minneapolis to evaluate factors associated with licensure and whether teens' travel patterns become more independent as they aged. We found that licensure depended not only on age, but on race and ethnicity as well as variables that correlate with household income. Results also showed evidence that teen travel became more independent as teen's age, and that acquiring a license is an important part of this increased independence. However, we found limited evidence that teen's travel-activity patterns changed as a result of acquiring a driver's license. Rather, teen independence resulted in less parental chauffeuring, but little shift in travel patterns. For the larger debate on declining Millennial mobility, our results suggest the need for more nuanced attention to variation across demographic groups and consideration of the equity implications if declines in travel and licensure are concentrated in low-income and minority populations.

Assessing multimodal school travel safety in North Carolina.

School transportation has been the subject of numerous federal and state policies since the early twentieth century-the Safe Routes to School program is the most recent example. However, few recent studies have thoroughly analyzed the risks and costs associated with different modes of transportation to school. Our descriptive study assessed the injury and fatality rates and related safety costs of different modes of school transportation using crash and exposure data from North Carolina, USA from 2005 to 2012. We found that riding with a teen driver is the most dangerous mode on a per trip basis with injury rates 20 times higher and fatality rates 90 times higher than school buses, which had the lowest injury rates. Non-motorized modes had per trip injury rates equivalent to school buses but per trip fatality rates were 15 times higher than for school buses. The economic costs of school travel-related injuries and fatalities for walking, biking, and teen drivers were substantially higher than other modes. This research has important policy implications because it quantified the risks of different school travel modes which allows policymakers to consider how safety investments can reduce risks. Decades of effort by schools, communities, and the government have made school buses a very safe mode and endeavored to reduce risks to teen drivers. This study highlighted the need for these same actors to reduce the risks of injury for walking and bicycling. As more improvements are made to infrastructure around schools, repeated studies of this type will allow practitioners to examine whether the improvements help mitigate the risks.

Assessing the distribution of safe routes to school program funds, 2005-2012.

BACKGROUND: The federal Safe Routes to School (SRTS) program was launched in 2005 to increase the safety of, and participation in, walking and biking to school. PURPOSE: This study assesses how SRTS funds were allocated to public and private schools and communities and whether there were demographic or locational differences between schools that benefited from SRTS funding and those that did not receive SRTS awards. METHODS: The study analyzes all SRTS projects awarded between 2005 and 2012 (N=5532) by using descriptive statistics to profile SRTS funding amounts and purposes, and to compare demographic and neighborhood characteristics of schools with and without SRTS programs. Analysis was conducted in 2013. RESULTS: The average SRTS award was $158,930 and most funding was spent on infrastructure (62.8%) or combined infrastructure and non-infrastructure (23.5%) projects. Schools benefiting from the SRTS program served higher proportions of Latino students and were more likely to be in higher-density areas. Few differences existed in neighborhood demographics, particularly educational attainment, work-trip commute mode, and median household income. CONCLUSIONS: Schools benefiting from the SRTS program are more urban and have higher Latino populations but are otherwise comparable to U.S. public schools. This suggests that disadvantaged areas have had access to the SRTS program.

U.S. school travel, 2009 an assessment of trends.

BACKGROUND: The White House Task Force on Childhood Obesity has set a goal of increasing walking and biking to school by 50% within 5 years. Meeting the goal requires a detailed understanding of the current patterns of school travel. PURPOSE: To document nationally representative estimates of the amount of school travel and the modes used to access school in 2009 and compare these levels with 1969, 1995, and 2001. METHODS: The National Household Travel Survey collected data on the travel patterns of 150,147 households in 2008 and 2009. Analyses, conducted in 2010, documented the time, vehicle miles traveled, and modes used by American students to reach school. A binary logit model assessed the influence of trip, child, and household characteristics on the decision to walk to school. RESULTS: In 2009, 12.7% of K-8 students usually walked or biked to school compared with 47.7% in 1969. Rates of walking and biking to school were higher on the trip home from school in each survey year. During the morning peak period, school travel accounted for 5%-7% of vehicle miles traveled in 2009 and 10%-14% of all private vehicles on the road. CONCLUSIONS: There have been sharp increases in driving children to school since 1969 and corresponding decreases in walking to school. This increase is particularly evident in the number of vehicle trips generated by parents dropping children at school and teens driving themselves. The NHTS survey provides a unique opportunity to monitor these trends in the future.

Reliability and validity of the Safe Routes to school parent and student surveys.

BACKGROUND: The purpose of this study is to assess the reliability and validity of the U.S. National Center for Safe Routes to School's in-class student travel tallies and written parent surveys. Over 65,000 tallies and 374,000 parent surveys have been completed, but no published studies have examined their measurement properties. METHODS: Students and parents from two Charlotte, NC (USA) elementary schools participated. Tallies were conducted on two consecutive days using a hand-raising protocol; on day two students were also asked to recall the previous days' travel. The recall from day two was compared with day one to assess 24-hour test-retest reliability. Convergent validity was assessed by comparing parent-reports of students' travel mode with student-reports of travel mode. Two-week test-retest reliability of the parent survey was assessed by comparing within-parent responses. Reliability and validity were assessed using kappa statistics. RESULTS: A total of 542 students participated in the in-class student travel tally reliability assessment and 262 parent-student dyads participated in the validity assessment. Reliability was high for travel to and from school (kappa > 0.8); convergent validity was lower but still high (kappa > 0.75). There were no differences by student grade level. Two-week test-retest reliability of the parent survey (n=112) ranged from moderate to very high for objective questions on travel mode and travel times (kappa range: 0.62-0.97) but was substantially lower for subjective assessments of barriers to walking to school (kappa range: 0.31-0.76). CONCLUSIONS: The student in-class student travel tally exhibited high reliability and validity at all elementary grades. The parent survey had high reliability on questions related to student travel mode, but lower reliability for attitudinal questions identifying barriers to walking to school. Parent survey design should be improved so that responses clearly indicate issues that influence parental decision making in regards to their children's mode of travel to school.

Vehicle emissions during children's school commuting: impacts of education policy.

We explore how school policies influence the environmental impacts of school commutes. Our research is motivated by increased interest in school choice policies (in part because of the U.S. "No Child Left Behind" Act) and in reducing bus service to address recent budget shortfalls. Our analysis employs two samples of elementary-age children, age 5-12: a travel survey (n = 1246 respondents) and a school enrollment data set (n = 19,655 students). Multinomial logistic regression modeled the determinants of travel mode (automobile, school bus, and walking; n = 803 students meeting selection criteria). Travel distance has the single greatest effect on travel mode, though school choice, trip direction (to- or from-school), and grade play a role. Several policies were investigated quantitatively to predict the impact on school travel, vehicle emissions, and costs. We find that eliminating district-wide school choice (i.e., returning to a system with neighborhood schools only) would have significant impacts on transport modes and emissions, whereas in many cases proposed shifts in school choice and bus-provision policies would have only modest impacts. Policies such as school choice and school siting may conflict with the goal of increasing rates of active (i.e., nonmotorized) school commuting. Policies that curtail bus usage may reduce bus emissions but yield even larger increases in private-vehicle emissions. Our findings underscore the need to critically evaluate transportation-related environmental and health impacts of currently proposed changes in school policy.