Air Pollution-Driven Parental Restrictions: Associations with Children’s Active School Transport in Urban and Rural India

Active school transportation (AST), including walking or cycling to school, is common among children and youth in India. However, rising air pollution and public health advisories may encourage parents to restrict outdoor activities. The role of parental restrictions on children’s and youths’ participation in AST remains largely unexplored. This study examines how parental restrictions on outdoor activity influence children’s and youths’ engagement in AST. We surveyed children and youth aged 5 to 17 from 41 schools across 28 urban and rural locations in five Indian states, collecting data on AST, parental restrictions, perceptions of air pollution, sociodemographic factors, and school distance. Data were analyzed using multiple logistic regression models, adjusted and unadjusted for children’s and youths’ perceptions of air pollution, segregated by age, gender, and location. Reported parental restrictions due to air pollution were associated with lower odds of engaging in AST overall (OR = 0.625, 95% CI = 0.400–0.971), for ages 5–12 (OR = 0.460, 95% CI = 0.208–0.985, and in urban areas (OR = 0.433, 95% CI = 0.198–0.881). Adjusting for children’s and youths’ air pollution perceptions, these associations persisted in overall and urban analyses. Living over 2 kilometres from school also lowered odds of AST participation (p < 0.05 across all models). The interplay between AST, air pollution, and parental restrictions is self-reinforcing: air pollution can trigger parents to restrict child and youth mobility and reduce AST and, in turn, lower AST may contribute to worsening air quality because of increased motorized transport. Integrated policies are required to simultaneously mitigate pollution and enhance active transportation infrastructure.