Background Previous studies have linked cycling with improved mental wellbeing but these studies tend to use cross-sectional survey data that have small sample sizes and self-reported health measures, and are potentially susceptible to omitted-variable bias and reverse causation. We use an instrumental variable approach and an objective measure of mental ill-health taken from linked administrative data to ask: ‘Does cycle commuting reduce the risk of mental ill-health?’ Methods Our study links data on commuting in Edinburgh and Glasgow from the Scottish population census with mental health prescriptions from the National Health Service Prescribing Information System records. We use road distance from home to nearest cycle path as an instrumental variable for cycle commuting. Results In total, 378 253 people aged 16–74 years living and working in the City of Edinburgh and Glasgow City council areas at the 2011 census were included in our study; 1.85% of commuters in Glasgow and 4.8% of commuters in Edinburgh cycled to work. Amongst cyclists, 9% had a prescription for mental health compared with 14% amongst non-cyclists. Using a bivariate probit model, we estimate a mean average reduction in prescriptions for antidepressants and/or anxiolytics in the 5 years following the census of –15.1% (95% CI: –15.3% to –15.0%) amongst cycle commuters compared with those who use any other mode to commute. Conclusions This work suggests that cycle commuting is causally related to reduced mental ill-health and provides further evidence in support of the promotion of active travel to encourage commuters travelling shorter distances to shift to cycle commutes.

中文翻译：

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骑自行车通勤会降低精神疾病的风险吗？使用到最近自行车道的距离进行工具变量分析

背景 先前的研究已将骑自行车与改善心理健康联系起来，但这些研究倾向于使用样本量较小和自我报告的健康指标的横断面调查数据，并且可能容易受到遗漏变量偏差和反向因果关系的影响。我们使用工具变量方法和从相关管理数据中获取的精神疾病客观衡量标准来询问：“骑自行车通勤是否会降低精神疾病的风险？” 方法我们的研究将苏格兰人口普查中的爱丁堡和格拉斯哥通勤数据与国家卫生服务处方信息系统记录中的心理健康处方联系起来。我们使用从家到最近自行车道的道路距离作为自行车通勤的工具变量。结果 2011 年人口普查中，我们的研究共纳入了 378 253 名年龄在 16-74 岁之间在爱丁堡市和格拉斯哥市议会辖区生活和工作的人；格拉斯哥 1.85% 的通勤者和爱丁堡 4.8% 的通勤者骑自行车上班。在骑自行车的人中，9% 的人有心理健康处方，而非骑自行车的人中这一比例为 14%。使用双变量概率模型，我们估计在人口普查后的 5 年内，骑自行车通勤者的抗抑郁药和/或抗焦虑药处方平均减少了 –15.1%（95% CI：–15.3% 至 –15.0%）。使用任何其他方式上下班的人。结论 这项工作表明，骑车通勤与减少精神疾病存在因果关系，并提供了进一步的证据来支持促进主动出行，鼓励短距离通勤者转向骑车通勤。