A Cost-Benefit Analysis of Physical Activity Using Bike/Pedestrian Trails

Abstract

From a public health perspective, a cost-benefit analysis of using bike/pedestrian trails in Lincoln, Nebraska, to reduce health care costs associated with inactivity was conducted. Data was obtained from the city's 1998 Recreational Trails Census Report and the literature. Per capita annual cost of using the trails was 209.28 U.S. dollars (59.28 U.S. dollars construction and maintenance, 150 U.S. dollars of equipment and travel). Per capita annual direct medical benefit of using the trails was 564.41 U.S. dollars. The cost-benefit ratio was 2.94, which means that every 1 U.S. dollar investment in trails for physical activity led to 2.94 U.S. dollars in direct medical benefit. The sensitivity analyses indicated the ratios ranged from 1.65 to 13.40. Therefore, building trails is cost beneficial from a public health perspective. The most sensitive parameter affecting the cost-benefit ratios were equipment and travel costs; however, even for the highest cost, every 1 U.S. dollar investment in trails resulted in a greater return in direct medical benefit.

A systematic review of economic analyses of active transport interventions that include physical activity benefits

“…Six of these were considered cost-effective (27,38,56,59,62,63). The study by Sinnett & Powell (55) evaluated Fitter for Walking projects in a number of locations and applied several assumptions.…”

“…Only eight studies reported their perspectives explicitly. Four applied a health sector perspective (58,62,64,65), one a public payer perspective (26), two a societal perspective (66,67) and one used both a health sector and a societal perspective (35). Economic evaluation entails the incremental assessment of both the costs and benefits of an intervention against an alternative option.…”

“…Morbidity outcomes -Five studies included only morbidity related outcomes associated with an increase in physical activity (27,37,45,58,62), with different approaches taken between studies. Four studies included health effects related to a potential change in physical activity through cost savings of diseases averted (27,37,45,58) although the specific diseases included varied (Appendix C).…”

“…Whilst influenced by the study perspective chosen, it is clear that little consensus exists around what impacts should be included and how to include them. Several studies were quite comprehensive in their inclusion of a range of potential benefits and disbenefits (27,34, 50, 54, 61), whilst others were not (39, 40,49,53,58,62). Environmental effects were the most included category (62.5% of studies), followed by the inclusion of the effects of accidents and injuries (50% of studies).…”

“…The context and relevance of the studies also differed between peer-reviewed and grey literature (CHEERS item 3). Generally, peer-reviewed studies presented a case for the inclusion of health outcomes of transport interventions or assessed changes in population health attributable to active transport and were undertaken to build the evidence for the inclusion of physical activity related health effects into transport appraisal (27,35,40,44,45,48,51,53,58,62,(64)(65)(66)(67). Studies from the grey literature and reference list searches were mostly reports developed by government or non-government organisations, with several of the economic evaluations being undertaken as supporting case -studies or as part of broader guiding documents (34, 37-39, 42, 46, 49, 50, 54-57, 59, 60, 63).…”