Monitoring active mobility in adults in Italy: trends and impacts on health and environment

Abstract Background Active mobility (AM) is a specific physical activity dimension and crosscutting topic to public health. It fosters the achievement of recommended World Health Organization (WHO) Physical Activity (PA) levels for noncommunicable disease (NCD) prevention, with environmental and social benefits. The profile description of people engaging in AM, estimating the number of preventable deaths, CO2 emissions reduction and saved costs is part of the work delivered by Istituto Superiore di Sanità as Italian country authority in the Joint Action PreventNCD. Methods Data on AM in adults residing in Italy (18-69) are from PASSI surveillance system. Sociodemographic variables and lifestyles (smoking, alcohol consumption, overweight, fruit and vegetables intake) were analysed by a multivariate logistic model. Using the WHO Health Economic Assessment Tool (HEAT), avoided deaths, CO2 emission reduction, and economic savings were estimated from the observed levels of AM. Results 197,000 adult individuals were interviewed between 2017 and 2023. We estimated a 42.9% prevalence of people that practice AM, with a 2% decrease between 2017 and 2023. AM is more frequent in non-smokers (OR 1.04, 95%CI: 1.01-1.07), high-risk alcohol consumers (OR 1.27, 95%CI: 1.21-1.29), individuals with normal weight (OR 1.12, 95%CI: 1.09-1.15), and those consuming at least three servings of fruit/vegetables daily (OR 1.24, 95%CI: 1.21-1.27). We estimated that the observed levels of AM correspond to 21,205 annual premature deaths and 1,038,058 tons of avoided CO2 emissions. The economic burden of these impacts was calculated using the value of statistical life (VSL) of $4,128,000 per avoided death, and social cost of carbon (SCC) of $74.5 per ton of CO2, with an annual economic value of 87.6 billion dollars. Conclusions Although slowly decreasing, AM is still practiced in Italy, with significant variations between sociodemographic groups. It should improve in adults to increase also e.g., in children. Key messages • Promoting active mobility improves public health, noncommunicable diseases prevention and mortality reduction. • Engaging in active mobility contributes to CO2 emissions decrease and economic advantages.