Health impacts of the M74 urban motorway extension: a mixed-method natural experimental study

Background: Making travel easier can improve people’s access to opportunities, but motor transport also incurs substantial undesirable health and social impacts. Aims: To assess how a new urban motorway affected travel and activity patterns, road accidents and well-being in local communities, and ho...

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Main Authors: David Ogilvie, Louise Foley, Amy Nimegeer, Jonathan R Olsen, Richard Mitchell, Hilary Thomson, Fiona Crawford, Richard Prins, Shona Hilton, Andy Jones, David Humphreys, Shannon Sahlqvist, Nanette Mutrie
Format: Article
Language:English
Published: NIHR Journals Library 2017-04-01
Series:Public Health Research
Subjects:
Online Access:https://doi.org/10.3310/phr05030
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author David Ogilvie
Louise Foley
Amy Nimegeer
Jonathan R Olsen
Richard Mitchell
Hilary Thomson
Fiona Crawford
Richard Prins
Shona Hilton
Andy Jones
David Humphreys
Shannon Sahlqvist
Nanette Mutrie
author_facet David Ogilvie
Louise Foley
Amy Nimegeer
Jonathan R Olsen
Richard Mitchell
Hilary Thomson
Fiona Crawford
Richard Prins
Shona Hilton
Andy Jones
David Humphreys
Shannon Sahlqvist
Nanette Mutrie
author_sort David Ogilvie
collection DOAJ
description Background: Making travel easier can improve people’s access to opportunities, but motor transport also incurs substantial undesirable health and social impacts. Aims: To assess how a new urban motorway affected travel and activity patterns, road accidents and well-being in local communities, and how these impacts were experienced and brought about. Design: The Traffic and Health in Glasgow study, a mixed-method controlled before-and-after study. Setting: Glasgow, UK. Participants: Repeat cross-sectional survey samples of 1345 and 1343 adults, recruited in 2005 and 2013, respectively. Of these, 365 formed a longitudinal cohort, 196 took part in a quantitative substudy using accelerometers and global positioning system receivers and 30, living within 400 m of the new motorway, took part in a qualitative substudy along with 12 other informants. Complementary analyses used police STATS19 road traffic accident data (1997–2014) and Scottish Household Survey travel diaries (2009–13). Intervention: A new 5-mile, six-lane section of the M74 motorway, opened in 2011 and running through predominantly deprived neighbourhoods in south-east Glasgow, with associated changes to the urban landscape. Main outcome measures: Differences in self-reported travel behaviour (1-day travel record), physical activity (short International Physical Activity Questionnaire) and well-being [Short Form 8 Health Survey (SF-8) and a short version of the Warwick–Edinburgh Mental Well-being Scale], and in the incidence of road traffic accidents. Methods: A combination of multivariable cohort, cross-sectional, repeat cross-sectional and interrupted time series regression analyses comparing residents of the ‘M74 corridor’ intervention area and two matched control areas, complemented by novel qualitative spatial methods. Graded measures of the proximity of the motorway to each participant’s home served as a further basis for controlled comparisons. Results: Both benefits and harms were identified. Cohort participants living closer to the new motorway experienced significantly reduced mental well-being (mental component summary of the SF-8 scale) over time compared with those living further away [linear regression coefficient –3.6, 95% confidence interval (CI) –6.6 to –0.7]. In the area surrounding an existing motorway, this association was concentrated among those with chronic conditions. In repeat cross-sectional analyses, participants living closer to a new motorway junction were more likely to report using a car at follow-up than those living further away (odds ratio 3.4, 95% CI 1.1 to 10.7). We found weaker quantitative evidence of a decline in physical activity participation and no quantitative evidence of an overall change in either active travel or accidents associated with motorway exposure. Qualitative evidence suggested that, although the new motorway improved connectivity for those with dispersed social networks and access to motor vehicles, the impacts were more complex for others, some of whom found the motorway to be a cause of severance. Changes in community composition and cohesion, and perceptions of personal safety, were widely perceived as more important to local people. Limitations: A key limitation of natural experimental studies is that the risk of residual confounding cannot be eliminated. Conclusions: Overall, these findings highlight the potential for urban infrastructural projects of this kind to add further burdens to already disadvantaged communities, exacerbating inequalities and contributing to poorer health outcomes. The health and social impacts of such initiatives should be more fully taken into account in planning and research. Funding: The National Institute for Health Research Public Health Research programme.
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spelling doaj.art-7ee6c9816e36437a95452e4c04608c822022-12-22T01:53:00ZengNIHR Journals LibraryPublic Health Research2050-43812050-439X2017-04-015310.3310/phr0503011/3005/07Health impacts of the M74 urban motorway extension: a mixed-method natural experimental studyDavid Ogilvie0Louise Foley1Amy Nimegeer2Jonathan R Olsen3Richard Mitchell4Hilary Thomson5Fiona Crawford6Richard Prins7Shona Hilton8Andy Jones9David Humphreys10Shannon Sahlqvist11Nanette Mutrie12Medical Research Council (MRC) Epidemiology Unit and Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, UKMedical Research Council (MRC) Epidemiology Unit and Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, UKMedical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UKCentre for Research on Environment, Society and Health, Institute of Health and Well-being, University of Glasgow, Glasgow, UKCentre for Research on Environment, Society and Health, Institute of Health and Well-being, University of Glasgow, Glasgow, UKMedical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UKNHS Greater Glasgow & Clyde, Glasgow, UKMedical Research Council (MRC) Epidemiology Unit and Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, UKMedical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UKNorwich Medical School and Centre for Diet and Activity Research (CEDAR), University of East Anglia, Norwich, UKDepartment of Social Policy and Intervention, University of Oxford, Oxford, UKSchool of Exercise and Nutrition, Deakin University, Geelong, VIC, AustraliaPhysical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UKBackground: Making travel easier can improve people’s access to opportunities, but motor transport also incurs substantial undesirable health and social impacts. Aims: To assess how a new urban motorway affected travel and activity patterns, road accidents and well-being in local communities, and how these impacts were experienced and brought about. Design: The Traffic and Health in Glasgow study, a mixed-method controlled before-and-after study. Setting: Glasgow, UK. Participants: Repeat cross-sectional survey samples of 1345 and 1343 adults, recruited in 2005 and 2013, respectively. Of these, 365 formed a longitudinal cohort, 196 took part in a quantitative substudy using accelerometers and global positioning system receivers and 30, living within 400 m of the new motorway, took part in a qualitative substudy along with 12 other informants. Complementary analyses used police STATS19 road traffic accident data (1997–2014) and Scottish Household Survey travel diaries (2009–13). Intervention: A new 5-mile, six-lane section of the M74 motorway, opened in 2011 and running through predominantly deprived neighbourhoods in south-east Glasgow, with associated changes to the urban landscape. Main outcome measures: Differences in self-reported travel behaviour (1-day travel record), physical activity (short International Physical Activity Questionnaire) and well-being [Short Form 8 Health Survey (SF-8) and a short version of the Warwick–Edinburgh Mental Well-being Scale], and in the incidence of road traffic accidents. Methods: A combination of multivariable cohort, cross-sectional, repeat cross-sectional and interrupted time series regression analyses comparing residents of the ‘M74 corridor’ intervention area and two matched control areas, complemented by novel qualitative spatial methods. Graded measures of the proximity of the motorway to each participant’s home served as a further basis for controlled comparisons. Results: Both benefits and harms were identified. Cohort participants living closer to the new motorway experienced significantly reduced mental well-being (mental component summary of the SF-8 scale) over time compared with those living further away [linear regression coefficient –3.6, 95% confidence interval (CI) –6.6 to –0.7]. In the area surrounding an existing motorway, this association was concentrated among those with chronic conditions. In repeat cross-sectional analyses, participants living closer to a new motorway junction were more likely to report using a car at follow-up than those living further away (odds ratio 3.4, 95% CI 1.1 to 10.7). We found weaker quantitative evidence of a decline in physical activity participation and no quantitative evidence of an overall change in either active travel or accidents associated with motorway exposure. Qualitative evidence suggested that, although the new motorway improved connectivity for those with dispersed social networks and access to motor vehicles, the impacts were more complex for others, some of whom found the motorway to be a cause of severance. Changes in community composition and cohesion, and perceptions of personal safety, were widely perceived as more important to local people. Limitations: A key limitation of natural experimental studies is that the risk of residual confounding cannot be eliminated. Conclusions: Overall, these findings highlight the potential for urban infrastructural projects of this kind to add further burdens to already disadvantaged communities, exacerbating inequalities and contributing to poorer health outcomes. The health and social impacts of such initiatives should be more fully taken into account in planning and research. Funding: The National Institute for Health Research Public Health Research programme.https://doi.org/10.3310/phr05030environmentinfrastructuremotorwaynatural experimental studyphysical activityroad traffic casualtiestravel behaviourwell-being
spellingShingle David Ogilvie
Louise Foley
Amy Nimegeer
Jonathan R Olsen
Richard Mitchell
Hilary Thomson
Fiona Crawford
Richard Prins
Shona Hilton
Andy Jones
David Humphreys
Shannon Sahlqvist
Nanette Mutrie
Health impacts of the M74 urban motorway extension: a mixed-method natural experimental study
Public Health Research
environment
infrastructure
motorway
natural experimental study
physical activity
road traffic casualties
travel behaviour
well-being
title Health impacts of the M74 urban motorway extension: a mixed-method natural experimental study
title_full Health impacts of the M74 urban motorway extension: a mixed-method natural experimental study
title_fullStr Health impacts of the M74 urban motorway extension: a mixed-method natural experimental study
title_full_unstemmed Health impacts of the M74 urban motorway extension: a mixed-method natural experimental study
title_short Health impacts of the M74 urban motorway extension: a mixed-method natural experimental study
title_sort health impacts of the m74 urban motorway extension a mixed method natural experimental study
topic environment
infrastructure
motorway
natural experimental study
physical activity
road traffic casualties
travel behaviour
well-being
url https://doi.org/10.3310/phr05030
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