Public and private transport, neighborhood disadvantage, and physical functioning: A gender-stratified study of mid-to-older adults in Brisbane, Australia

Promoting physical functioning is essential for healthy aging, and the built environment is recognized as a key modifiable influence on this health outcome. While the association between public transport accessibility and physical functioning in mid-to-older adults has been studied, the role of private and public transport modes in relation to physical functioning remains underexplored. Research has overlooked how these relationships differ by gender; however, evidence consistently shows women are more vulnerable to decline in physical functioning. Data from 3348 participants (aged 49–76 years) living in Brisbane, Australia, as part of the “How Areas in Brisbane Influence healTh and ActiviTy” (HABITAT) study were used to investigate associations between private or public transport, neighborhood disadvantage, and self-reported physical functioning for men and women separately. Results showed that women using public transport have higher physical functioning than their private transport counterparts. Living in more disadvantaged neighborhoods was associated with higher physical functioning for women using public transport, demonstrating the moderator effect of transport mode in the association between neighborhood disadvantage and physical functioning. Transport mode also moderated the association between public transport accessibility and physical functioning for women. Living 1 km closer to bus stops and train stations increased physical functioning scores by 10.36 and 1.30 points, respectively, for women using public transport compared with their private transport using counterparts. In contrast, no significant associations were found for men. These results underscore the need for policymakers to prioritize accessibility to public transport to maintain the physical functioning of women, especially in disadvantaged areas.