Constraints to travel outside the local area: Effect on social participation and self-rated health

Abstract

Background: Travel outside the local area allows people to meet others and access a wide selection of services and opportunities. However, travel can be constrained by the lack of good transport or by personal factors. This paper investigates whether these constraints are associated with poor self-rated health, and the extent to which the association is mediated by reduced social participation. Method: Respondents in a survey in the North of England (n = 2747) stated levels of constraints to trip frequency, number of places visited, travel distance, and travel mode for trips more than 15 miles (24 km) away from home. Path analysis tested associations between these constraints, indicators of social participation (seeing family and friends frequently and being a member of clubs or societies), and self-rated health. Results: Constraints to the number of places visited were associated with self-rated health via reduced social participation. Constraints to trip frequency had a negative association with self-rated health via pathways other than social participation. Constraints to travel distance were not significant and constraints to car use and public transport use were associated with self-rated health via other constraints. The results varied by age group and were robust to changes in variable specification and treatment of missing data. Conclusions: The results confirm the importance of being able to travel outside the local area for social participation and health and emphasize the need for public policies that reduce constraints to travel, by providing better conditions for the use of both private and public transport and for the realization of more frequent trips to a wider set of places.