Abstract:ObjectivesTo conduct a health economic evaluation of a proposed investment in urban bicycle infrastructure in Stockholm County, Sweden.DesignA cost-effectiveness analysis is undertaken from a healthcare perspective. Investment costs over a 50-year life cycle are offset by averted healthcare costs and compared with estimated long-term impacts on morbidity, quantified in disability-adjusted life years (DALYs). The results are re-calculated under different assumptions to model the effects of uncertainty.SettingTh… Show more
“…Currently, health economic assessments of air pollution have assumed immediate health effects due to the knowledge gap regarding lag times between exposure and effect. As discussed previously [ 34 , 35 ], it is reasonable to assume that some time after the exposure decrease is needed before expected health effects occur. In previous studies, this has been highlighted as an important limitation, which has hindered the knowledge transfer between interdisciplinary research fields and policymaking.…”
Long-term air pollution exposure increases the risk for cardiovascular disease, but little is known about the temporal relationships between exposure and health outcomes. This study aims to estimate the exposure-lag response between air pollution exposure and risk for ischemic heart disease (IHD) and stroke incidence by applying distributed lag non-linear models (DLNMs). Annual mean concentrations of particles with aerodynamic diameter less than 2.5 µm (PM2.5) and black carbon (BC) were estimated for participants in five Swedish cohorts using dispersion models. Simultaneous estimates of exposure lags 1–10 years using DLNMs were compared with separate year specific (single lag) estimates and estimates for lag 1–5- and 6–10-years using moving average exposure. The DLNM estimated no exposure lag-response between PM2.5 total, BC, and IHD. However, for PM2.5 from local sources, a 20% risk increase per 1 µg/m3 for 1-year lag was estimated. A risk increase for stroke was suggested in relation to lags 2–4-year PM2.5 and BC, and also lags 8–9-years BC. No associations were shown in single lag models. Increased risk estimates for stroke in relation to lag 1–5- and 6–10-years BC moving averages were observed. Estimates generally supported a greater contribution to increased risk from exposure windows closer in time to incident IHD and incident stroke.
“…Currently, health economic assessments of air pollution have assumed immediate health effects due to the knowledge gap regarding lag times between exposure and effect. As discussed previously [ 34 , 35 ], it is reasonable to assume that some time after the exposure decrease is needed before expected health effects occur. In previous studies, this has been highlighted as an important limitation, which has hindered the knowledge transfer between interdisciplinary research fields and policymaking.…”
Long-term air pollution exposure increases the risk for cardiovascular disease, but little is known about the temporal relationships between exposure and health outcomes. This study aims to estimate the exposure-lag response between air pollution exposure and risk for ischemic heart disease (IHD) and stroke incidence by applying distributed lag non-linear models (DLNMs). Annual mean concentrations of particles with aerodynamic diameter less than 2.5 µm (PM2.5) and black carbon (BC) were estimated for participants in five Swedish cohorts using dispersion models. Simultaneous estimates of exposure lags 1–10 years using DLNMs were compared with separate year specific (single lag) estimates and estimates for lag 1–5- and 6–10-years using moving average exposure. The DLNM estimated no exposure lag-response between PM2.5 total, BC, and IHD. However, for PM2.5 from local sources, a 20% risk increase per 1 µg/m3 for 1-year lag was estimated. A risk increase for stroke was suggested in relation to lags 2–4-year PM2.5 and BC, and also lags 8–9-years BC. No associations were shown in single lag models. Increased risk estimates for stroke in relation to lag 1–5- and 6–10-years BC moving averages were observed. Estimates generally supported a greater contribution to increased risk from exposure windows closer in time to incident IHD and incident stroke.
“…Investing in urban infrastructure to increase bicycling is cost-effective from a healthcare perspective. Yet, these studies should, in future, account for societal benefits such as obesity reduction and environmental effects such as air pollution concentration decreases due to multiple factors, since the authors believe the cost savings and health benefits are underestimated [67]. Alternatively, a life cycle cost analysis could consider the recent disruptive innovations and research needs in each of the following five themes, with impact on economic sustainability or with social impacts, such as in the form of safety costs.…”
Section: Parallel Research Areas Of Micromobility Sustainability-soci...mentioning
Micromobility is an increasingly attractive option, particularly over short distances. Walking, biking, and other modes of transport, such as e-scooters, are gaining popularity. Furthermore, a trend is emerging to introduce appealing items onto the market that incorporate new/more sustainable materials to improve wellbeing. Significant research questions concern the understanding of emerging research needs and the environmental, social, and economic effects of sustainability in the micromobility transport system, specifically because of developing and implementing new products, boosting the safety and comfort of ergonomic personal mobility devices (PMDs), and assuring security and privacy while digitalization arises. Such research topics can raise policymakers’ and the public’s awareness while providing impactful information for decision-makers. This paper provides a literature review of the most recent research on micromobility-related topics. It uses scientific databases, a keywords list, and defined inclusion criteria to select data, analyze content, and perform a bibliometric analysis. The findings highlight the significance of using Life Cycle Assessment (LCA) tools together with other methodologies to aid in the evaluation of urban complexity. Finally, using a life cycle thinking (LCT) approach, we propose a framework for comprehensively integrating identified research needs.
“…Likewise, a daily exercise of cycling just 3.4 km in urban areas of England and Wales will reduce the cost of healthcare by 0.8% [ 32 ]. In Sweden, the net benefit from a 15% increase in the number of bicycle commuters in Stockholm was estimated at 8.7% of the municipality’s healthcare budget (3.7% after discounting) [ 39 ]. An investment in sidewalks in a Wisconsin community suggests a cost-benefit ratio of 1.81 [ 27 ].…”
Purpose of Review
The study aims to provide an understanding of health cost assessments of different transport modes in urban contexts, and their relevance for transport planning and political decision-making.
Recent Findings
There is strong evidence that motorized transportation imposes a high health cost on society, and specifically children. In contrast, active transport is a very significant health benefit.
Summary
Economic analyses support urban change in favor of compact neighborhoods and public transit, as well as infrastructure exclusively devoted to active transport. Private cars need to be restricted because of the high cost they impose on society.
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