Health Impacts of Increased Physical Activity from Changes in Transportation Infrastructure: Quantitative Estimates for Three Communities.
Recently, two quantitative tools have emerged for predicting the health impacts of projects that change population physical activity: the Health Economic Assessment Tool (HEAT) and Dynamic Modeling for Health Impact Assessment (DYNAMO-HIA). HEAT has been used to support health impact assessments of transportation infrastructure projects, but DYNAMO-HIA has not been previously employed for this purpose nor have the two tools been compared. To demonstrate the use of DYNAMO-HIA for supporting health impact assessments of transportation infrastructure projects, we employed the model in three communities (urban, suburban, and rural) in North Carolina. We also compared DYNAMO-HIA and HEAT predictions in the urban community. Using DYNAMO-HIA, we estimated benefit-cost ratios of 20.2 (95% C.I.: 8.7-30.6), 0.6 (0.3-0.9), and 4.7 (2.1-7.1) for the urban, suburban, and rural projects, respectively. For a 40-year time period, the HEAT predictions of deaths avoided by the urban infrastructure project were three times as high as DYNAMO-HIA's predictions due to HEAT's inability to account for changing population health characteristics over time. Quantitative health impact assessment coupled with economic valuation is a powerful tool for integrating health considerations into transportation decision-making. However, to avoid overestimating benefits, such quantitative HIAs should use dynamic, rather than static, approaches.
Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 148A Rosenau Hall, CB No. 7431, Chapel Hill, NC 27599, USA.
Theodore J
TJ
Mansfield
Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 148A Rosenau Hall, CB No. 7431, Chapel Hill, NC 27599, USA.
Jacqueline
J
MacDonald Gibson
D000328:Adult; D001642:Bicycling / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus; D005260:Female; D062489:Health Impact Assessment; D006801:Humans; D006973:Hypertension; D008297:Male; D015233:Models, Statistical; D009657:North Carolina; D018570:Risk Assessment; D020521:Stroke; D014186:Transportation; D016138:Walking / Q000706:statistics & numerical data*