How does the cost of public transport affect mental health and wellbeing?

The cost of transport is an important determinant of mode choice and often a significant contributor to household expenditure. Several jurisdictions have introduced subsidised or free public transport in pursuit of sustainability, health, and equity goals. Within the wider literature on transport and health, evidence on the relationship between public transport cost and mental health and wellbeing has not been reviewed. This chapter reports the findings of a systematic review of peer-reviewed and grey literature on the impact of the financial cost of public transport on mental health and wellbeing. We included studies reporting the relationship between the financial cost of public transport (including interventions which affect this, such as subsidies and concessionary passes) on quantitative measures of mental health, mental illness, and/or mental wellbeing, among any group of people who use public transport or who have the potential to do so. We searched six bibliographic databases; two grey literature repositories; and five Organizational websites, and undertook forward and backward citation review. Eligible studies were assessed for quality using the JBI Critical Appraisal Tool set, and results were synthesised narratively.
We identified six eligible studies from an initial 9,253 records. All included studies examined concessionary public transport passes or reduced fares available to specific population groups (primarily older adults, though one study focused on young people). All six suggested that these interventions to reduce the cost of public transport had a positive impact on mental health and wellbeing. This association appeared to be stronger among those who travelled most frequently; as the availability and frequency of public transport improved; and among lower-income groups. The geographical scope of the studies was limited to the UK and USA, and no studies examined the impacts of real-world increases in costs or reduced affordability of transport. In the context of efforts to enhance public transport uptake, and global increases in the cost-of-living, we suggest that this is an area which merits further research in order to inform policy decisions about the affordability of public transport.