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Carolyn DiGuiseppi Child Health Monitoring Unit, Department of
Epidemiology and Public Health, Institute of Child Health, University
College London Medical School, London WC1N
1EH
Correspondence to: Dr DiGuiseppi
C.DiGuiseppi{at}ich.ucl.ac.uk
The annual distance walked by children has fallen 28%
since 1972, partly because car travel has replaced walking on many
school journeys.1 Increasing car use has been linked with
obesity, adverse health effects in later life, limitations on
children's independence, traffic congestion, and
pollution.
2 3
To inform the development of strategies to
reduce school related car travel, we surveyed the travel patterns of
urban primary school children.
The survey was conducted in the inner London boroughs of Camden
and Islington. The questionnaire We used logistic regression, including a random effect (school) to
account for cluster sampling, to estimate odds ratios and 95%
confidence intervals for determinants of car travel versus walking. We
excluded pupils who used public transport.
Thirty schools (97%) agreed to participate. Of 2476 enrolled children,
2086 (84%) returned usable questionnaires: 96% English, 2% Bengali,
1% Turkish, and 1% English and Bengali (duplicate versions returned).
Response rates were highest in independent schools (96%) and lowest in
local authority schools (81%). Excluding independent schools, for
which the information was unavailable, the respondents' ethnic
distribution (54% white, 18% black, 14% Asian, and 15% other) was
similar to that of the school population (50% white, 18% black, 15%
Asian, 17% other).
Most children walked (69%) or travelled by car (26%). Four (0.2%)
cycled, and the rest travelled by bus, underground, or train (5%).
Proportions were similar for the journey home. Adults accompanied 84%
of children to and from school. Most children (61%) were rarely or
never allowed out without an adult for school or leisure. Only 3% of
bicycle owners were allowed to cycle on main roads. Ninety per cent of
parents were very or quite worried about abduction or molestation, and
89% were very or quite worried about traffic. The strongest predictors
of car travel to school were car ownership, greater distance to school,
attendance at an independent school, and parental worry about abduction
(table). For the journey home, the strongest predictors were greater
distance to school, car ownership, and attending an independent school.
Distance to school and car ownership were principal determinants
of car travel. After adjustment for these factors, children at
independent schools were still more likely to travel by car. Parental
fear about "stranger danger" also influenced the decision to drive
children to school.
Although few translated questionnaires were requested, the study
population adequately represented the ethnic distribution of children
attending school in the two boroughs. Our results might appropriately
be generalisable to other urban primary school populations.
Increasing emphasis on school choice has been accompanied by a 20%
increase in average distance travelled to school.1
Policies that encourage children to attend nearby schools are likely to reduce car travel and increase walking. Parents who currently drive
their children might forgo the car for safe, convenient alternatives
that address their fears. Unless such alternatives are developed,
parents who do not currently drive to school are likely to do so when
the option becomes available.
This study originated from joint work with the Camden and
Islington Accident Prevention Alliances.
Contributors: CD designed the protocol and questionnaire,
implemented the study, and participated in the study design, data
analysis and interpretation, and writing the paper. IR initiated the
research and participated in study and questionnaire design, data
analysis and interpretation, and writing the paper. LL performed data
analysis and edited the paper. DA managed and audited the data,
performed preliminary analyses, and edited the paper. We received
helpful advice on questionnaire and study development from Mayer
Hillman, Belita Clahar, Michelle Walsh, and Suzanne Slater, and on
statistical analysis from David Dunn. We acknowledge the assistance of
Jackie Payne, Elaine Morrison, the local education authorities in
Camden and Islington, and the participating schools, teachers, and
pupils.
Funding: The London Boroughs of Camden and Islington funded the
study. The Camden and Islington Health Authority funded CD and DA.
Conflict of interest: None.
(Accepted 5 February 1998)
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Methods and results
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Methods
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based partly on published surveys
4 5
and prepared in English, Bengali, Turkish,
Greek, and Cantonese (first languages of 85% of eligible
pupils)
asked about that day's school journey, children's
independent travel, and parental concerns. From the sampling frame of
all primary schools (excluding pilot, boarding, and special schools),
31 of the 100 eligible schools were randomly selected. We weighted
sampling probability by combined class sizes in year 2 (ages 6-7 years) and year 5 (ages 9-10). Questionnaires, with a letter from the head
teacher and a multilingual request form for translation, were
distributed to pupils for completion at home. Questionnaires were left
for absentees. One week later, we collected completed questionnaires,
gave new questionnaires to non-respondents, and distributed requested
translations. All pupils were given pencil cases.
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Acknowledgments
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© BMJ 1998