Active mobility and mental health: A scoping review towards a healthier world

Abstract

Research has proven that engaging in active mobility (AM), namely walking and cycling for transportation, significantly enhances physical activity levels, leading to better physical health. It is still unclear whether AM could also offer any mental health benefits. This scoping review aims to provide a comprehensive understanding of the current knowledge on the relationship between AM and mental health, given its crucial role in public health. The authors searched online databases to isolate primary studies written in English involving an adult sample (16 or over). AM was the exposure factor. Many mental health elements were included as outcomes (depression, anxiety, self-esteem, self-efficacy, stress, psychological and subjective well-being, resilience, loneliness and social support, quality of life, mood, life satisfaction and sleep). The results were organised in a narrative summary per each outcome selected, graphical syntheses and an overview of gaps to be further examined. The authors identified a total of 55 papers as relevant. The results show inconsistency in study designs, definition and operationalisation of the variables, approach and methodologies used. A cross-sectional design was the dominant choice, primarily examining data from national public health surveys. Nonetheless, there has been improvement in outcomes of interests, initially mainly the quality of life and affect. Lately, authors have focused on a broader range of mental health-related factors (such as travel satisfaction). The experimental studies showed promising mental health improvements in those who used active modes more than those who used motorised vehicles. It creates a rationale for further research towards implementing a unified theoretical and methodological framework to study the link between AM and mental health. The ultimate goal is to generate solid conclusions that could support building societies and cities through public health promotion and sustainable strategies, like walking and cycling as a means of transport.

Keywords: global public health; lifestyle; mental health; quality of life; sustainable development.

Graphical abstract

Figure 1.

PRISMA 2020 flow diagram for new systematic reviews which included searches of databases and registers only.

Figure 2.

Word clouds summarising the most common study-specific phrases found in articles included in the review are categorised as (a) related to outcomes or (b) related to covariates. The size of the text is proportional to the relative number of occurrences of the phrase.

Figure 3.

The study distribution in the review is projected onto the world map (left panel), while European studies are shown in the enlargement (right panel). The size of the symbols is related to the number of participants. The location of each symbol is centred on the centre of the city, region or country from which participants were drawn.

Figure 4.

Albatross plots mapping the imputed effect size of each study for which data were available regarding differences in outcome between study participants selecting active and motorised mobility for transport needs in daily life. Curved lines join points with equal effect sizes (labelled 0.1, 0.25, 0.5). The x-axis indicates the reported p-value. Points to the right of the origin (null p-value) show a benefit for active mobility, and those to the left show a benefit for motorised transport. The y-axis shows the number of participants on a logarithmic scale. Points are positioned conservatively when only the relationship to a significance threshold is reported (i.e., p < 0.05 is treated as p = 0.05). Results are divided between four panels for easier visualisation, grouping outcomes by alphabetical order. Symbol shapes indicate study design (legend in the bottom right-hand panel). Labels indicate the first three letters of the first author’s name and the 2-digit year of publication.