title: Urban greenways have the potential to increase physical activity levels cost-effectively.
abstract: BACKGROUND
  For many, physical activity has been engineered out of daily life, leading to high levels of sedentariness and obesity. Multi-faceted physical activity interventions, combining individual, community and environmental approaches, have the greatest potential to improve public health, but few have been evaluated.
  
  
  METHODS
  Approximately 100,000 people may benefit from improved opportunities for physical activity through an urban regeneration project in Northern Ireland, the Connswater Community Greenway. Using the macro-simulation PREVENT model, we estimated its potential health impacts and cost-effectiveness. To do so, we modelled its potential impact on the burden from cardiovascular disease, namely, ischaemic heart disease, type 2 diabetes mellitus and stroke, and colon and breast cancer, by the year 2050, if feasible increases in physical activity were to be achieved.
  
  
  RESULTS
  If 10% of those classified as 'inactive' (perform less than 150 minutes of moderate activity/week) became 'active', 886 incident cases (1.2%) and 75 deaths (0.9%) could be prevented with an incremental cost-effectiveness ratio of £4469/disability-adjusted life year. For effectiveness estimates as low as 2%, the intervention would remain cost-effective (£18 411/disability-adjusted life year). Small gains in average life expectancy and disability-adjusted life expectancy could be achieved, and the Greenway population would benefit from 46 less years lived with disability.
  
  
  CONCLUSIONS
  The Greenway intervention could be cost-effective at improving physical activity levels. Although the direct health gains are predicted to be small for any individual, summed over an entire population, they are substantial. In addition, the Greenway is likely to have much wider benefits beyond health.
authors.affiliation: 1 Centre for Public Health, Queen's University Belfast, Institute of Clinical Science, Belfast BT12 6BJ, Northern Ireland, UK.
authors.forename: Mary Anne T
authors.initials: MA
authors.lastname: Dallat
authors.forename: Isabelle
authors.initials: I
authors.lastname: Soerjomataram
authors.forename: Ruth F
authors.initials: RF
authors.lastname: Hunter
authors.forename: Mark A
authors.initials: MA
authors.lastname: Tully
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Cairns
authors.forename: Frank
authors.initials: F
authors.lastname: Kee
mesh_terms: D002908:Chronic Disease / Q000517:prevention & control; D002958:City Planning; D003362:Cost-Benefit Analysis; D004779:Environment Design; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009043:Motor Activity; D009660:Northern Ireland; D011634:Public Health; D011788:Quality of Life; D019057:Quality-Adjusted Life Years