Funded projects

This study aims to assess the impact of free bus travel for young people on the health of the public. We will focus particularly on the effects on young people, but also intend to look at the consequent effects on other population groups for some outcomes.

In London, young people aged under 16 have been able to access free bus and tram travel since September 2005. This was extended to under 18 year olds in education, work or training in September 2006. One incentive for this policy was to decrease 'transport exclusion', and ensure that access to goods, services, education and training opportunities were not denied to some young people because of transport poverty. We would expect that this would increase health, as transport access is linked to well-being. However, there will be other health effects of free bus travel. These might include: young people walking less often or less far, and thus taking less exercise, or being more exposed to minor crime and assault as they travel further for longer distances. Free bus travel for young people might also reduce access other age groups have to transport if, for instance, the buses become too full, or older people are intimidated. Like other complex public policies, there are likely to be both health promoting and health damaging effects.

To assess these effects, we will begin with qualitative research talking young people and older citizens from a range of backgrounds to find out how they experience transport, and the ways in which they feel that access and use influences their health, and the broader determinants of health (eg: access to safe places to play and leisure facilities; opportunities for independent travel). An important element of this component of the project is to understand better how transport interventions can have differential effects on different population groups (eg by ethnicity, or deprivation).

This study then aims to measure as robustly as possible the overall impact on population health of this transport intervention. We will do this by first looking in detail at travel diary data to measure whether there have been any changes in the amount of bus and other kinds of transport undertaken by young people and others before and after the introduction of free bus travel. This will allow us to estimate the effect on access to transport, and on the amount of healthier 'active transport' (walking and cycling). Using comparisons between different age groups (with and without access to free travel) and national data will allow us to estimate how much of the change is due to the policy, and how much due to general changes in people's transport use. We will then look at the impact on injuries, both road traffic injuries and assaults, by using police records of traffic incidents and other available data sets (eg bus incident reports). Again, comparing these with national data and other cities, and comparing different age groups affected and not affected by the intervention will allow us to estimate how far changes identified are due to the intervention itself, and how far they reflect general background trends in, for instance, changes in the amount of walking or rates of injuries.

The need for public policy to be developed in the light of evidence is increasingly recognised, and we also aim to develop methods for developing this evidence base. This is a challenge, as transport interventions occur at the same time as other changes, and we need to develop methods to assess how far they have caused the effects we are measuring. Finally, we will draw on the transport studies literature on evaluating the costs and benefits of transport strategies to investigate the costs and benefits of this policy, from the perspectives of the economy, environment and society.

There has been increasing interest in the ways in which transport policies affect the public health but to date, few robust evaluations of specific policies. This study aims to evaluate the impact of the introduction of free bus and tram travel to under 16 year olds in 2005 and under 18 year olds in 2006 in London. The aims of this policy included reducing transport exclusion among young people. This potentially had a positive effect on the determinants of health and health equity. However, there has also been concern that extending access to bus travel may have reduced the amount of healthier 'active transport' done by young people. There are also concerns about consequent impacts on other population groups, such as elderly people. Using a mixed method, quasi-experimental design, this study aims to provide empirical evidence for the impact of free bus travel on public health, and evaluate the economic costs and benefits. The objectives are to:

1. Determine the causal pathways that plausibly link transport interventions and young people's health.

2. Identify the ways in which young people and older citizens understand the role of bus and other transport mode access in facilitating and constraining their well being.

3. Assess the impact of the intervention on the use of bus and other (particularly active) transport modes for young people and other age groups.

4. Identify the impact of the intervention on injury rates.

5. Develop and apply methods for conducting an economic evaluation of the health impacts of free bus travel.

This study will also contribute to the development of methods to evaluate the public health impact of interventions in complex systems in the absence of RCT evidence.