Active Travel to and From School Among School-Age Children During 1997-2011 and Associated Factors in China

Active travel to school (ATS) is positively associated with various health indicators. The rapid social, economic, and environmental changes in China provide a unique setting to study changes and predictors of ATS over time. Methods: Using logistic regression modeling, we analyzed data from the China Health and Nutrition Survey during 1997 to 2011 (N = 9487, ages 6 to 17 years) to estimate the change over time in ATS and to identify associated factors. Results: The prevalence of reported ATS among children dropped from 95.8% in 1997 to 69.3% in 2011. ATS was common in children living closer to school, in middle school, from low-income households, with low parental education status, and those without a private vehicle. Children who were living in a metropolitan area and who had more than 40 minutes of total PA per day were less likely to report ATS. Conclusions: The decrease of ATS had been concurrent with the increase of the children living at a longer distance from school and the increase of household owning private vehicles which were associated with the rapid urbanization and economic growth in China. Factors associated with the decreased ATS in China are similar to other countries but the underlying reasons may be different.