Air Pollution and Active School Transportation: Perceptions of Children and Youth in India

Background: Active school transportation (AST), including walking or cycling, is a common practice across India contributing to physical activity accumulation among children and youth. However, as climate change and severe heat waves exacerbate poor air quality, it is important to understand air pollution’s impact on AST.

Purpose: This study aimed to examine the association between perceptions of air pollution and AST among children and youth in both rural and urban India.

Methods: This cross-sectional, observational study was conducted during the Coronavirus disease lockdown in India in 2021. The study implemented a multi-stage stratified random sampling method involving urban and rural schools in five Indian states across 28 different cities and villages. Using online surveys, children and youth (N=1042) self-reported information on various sociodemographic, environmental, and behavioral factors, including perception of air pollution and AST. Multivariable logistic regression models were conducted adjusting for age, gender, location, and socioeconomic status.

Results: The perception of air pollution was associated with a lower likelihood of engaging in AST in the 5- to 12-year age group, but not in the 13- to 17-year age group. Similarly, males and rural residents who perceived air pollution were less likely to engage in AST; however, this association was not found in females or urban residents.

Conclusions: This is the first study in India to explore the relationship between air pollution perceptions and AST across rural and urban cohorts, with the findings highlighting varied impacts of air pollution on cycling and walking among children and youth.

Practical Implications: Child and youth perceptions of air pollution can not only inform the design of targeted AST interventions considering sociodemographic differences among Indian children and youth, but also enable public health advisories for air quality and safe outdoor activity.

Funding: This research was supported by the Hirabai Cowasji Jehangir Medical Research Institute.