Health and travel: How might traveling benefit health?

• According to a new survey-based study on a population from the United Kingdom, constraints on travel outside of one’s local area are associated with poorer self-reported health.
• In contrast, people who travel away from their home location report experiencing better health.
• One reason might be that when a person is unable to travel, they also have fewer social interactions, which may contribute to loneliness.
• The study focuses on the North of England, an area with poorer health outcomes than the rest of England, and limited transportation services outside of large urban areas.

A new, survey-based study conducted by researchers at University College London’s Centre for Transport Studies, in the United Kingdom, shows how people feel that travel — and barriers to travel — impact their health.

The study finds that people who face constraints on their ability to travel outside their local area, or to as many places as they would like, report poorer health, whereas those who are able to travel away from home feel that they experience better health.

Its findings appear in the Journal of Transport & Health.

The researchers received funding from the U.K. transport body Transport for the North for their study.

How the study proceeded

The study defined traveling outside one’s local area as traveling 15 miles, or 24 kilometers, away from home.

The study authors analyzed responses from 2,747 residents from the North of England regarding their health and the constraints to travel that they face.

This area of England has the nation’s worst health outcomes, according to the researchers, and many of its areas lack adequate transportation facilities.

The survey respondents were asked to report their level of agreement or disagreement with five questions, each of which focused on a specific travel constraint:

• “I travel beyond my local area less often than I would ideally like to” — a travel frequency constraint
• “I travel to fewer places (e.g., cities or towns outside my local area) than I would ideally like to” — a constraint on the number of places traveled
• “I travel to places that are nearer than the ones I would ideally like to go” — a travel distance constraint
• “I travel by public transport to places I would ideally like to go by car” — a travel-by-car constraint
• “I travel by car to places I would ideally like to go by public transport” — a constraint on access to public transportation.

Based on the survey responses, the authors concluded that individuals who were able to travel at least 15 miles away from home, and who were able to travel frequently and see more places were more likely to report better health.

The associations between travel and state of health were more significant in respondents aged 55 years and over.

Restricted social interaction

According to lead author Dr. Paulo Anciaes, previous research has established that the ability to travel can increase access to employment and educational opportunities. He hoped to investigate, for the first time, the effect of travel on health.

He told Medical News Today that the North of England was chosen as the area of study because it lags behind the rest of the country. “The government has, as one of its main priorities, the ‘leveling up‘ of the North and other lagging regions,” he said.

“The health outcomes are consistently worse [in the North] than in the South,” Dr. Anciaes noted, “and statistics and studies suggest that this is mainly explained by the lower incomes. Our study tried to uncover other possible reasons. We found that the ability to travel is one of them.”

To assess the effect of travel on health, Dr. Anciaes and his co-author, Dr. Paul Metcalfe, employed a technique called “path analysis” that made it possible for them to observe the direct and indirect effects of one variable on another.

The researchers found that when people were limited in the number of places they could go, the lack of opportunities for social interaction was directly linked to poorer health.

On the other hand, constrained travel frequency negatively affected health less directly. That is, he said, “travel constraints are significantly related to social participation, and social participation is then significantly related to self-reported health.”

Traveling outside one’s local area can also have a direct effect on health quality, in that it may allow people to access more, and perhaps better, healthcare options than might be available closer to home.

The impact of social connections on health

Lifestyle medical educator Dr. Elizabeth Pegg Frates, who was not involved in the study, told MNT:

“It is clear that social connection is a basic human need. After our need for water, food, and shelter, we have a need for belonging, or social connection.”

Dr. Frates said there is ample research describing the effect a lack of social connectedness can have on health: “Research from 1979 demonstrated that the people who lacked social and community ties were the most likely to die in a nine-year prospective study. With lack of social interaction often comes loneliness.”

“Loneliness has been reported to be associated with heart attacks, cancer, delayed cancer recovery, progression of heart disease, high blood pressure, and slower wound healing,” she pointed out. “Also, a recent study indicates that loneliness may be associated with the development of type 2 diabetes.”

Dr. Frates has co-authored an article for the American Journal of Lifestyle Medicine describing the positive benefits of social connections on health.

‘The possibility to travel is important’

“The study shows,” said Dr. Anciaes, “that the possibility to travel is important for the health of populations. The implication is that constraints to travel need to be removed.”

He cited as such constraints an insufficient level of transport services, particularly in rural areas, and the absence of services beyond the peak travel hours of the day, or on weekends and during school holidays.

The cost of transportation can also be an issue, as is a lack of personal security, crowded facilities, and poor accessibility for older and disabled passengers.

For people who would like to be able to travel more by car but are inhibited by the costs of owning and using one, Dr. Anciaes suggested that relevant authorities could provide “subsidies to poorer households using a private car when they live in areas with no public transport.”

Dr. Anciaes noted that improving public transport would also make car driving easier by reducing the number of vehicles on the road.

Dr. Patricia L. Mokhtarian of the School of Civil and Environmental Engineering at Georgia Tech was not involved in the study, but endorsed the importance of travel, telling MNT in no uncertain terms that, “[f]undamentally, travel is essential to health and well-being — if we aren’t moving, we are dead.”

She admitted, however, that promoting travel “presents something of a policy/ planning dilemma,” considering the resulting increased environmental burden when more people travel more.

Nonetheless, said Dr. Mokhtarian, “[t]he well-being benefits are manifold. There’s [a] sizable literature on the latter, including much of my own work.”

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