The new WHO Health Economic Assessment Tool for Walking and Cycling - an introduction

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Cory Gilmore
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EBPI, Physical Activity and Health Unit Rutter H, Cavill N, Schweizer C, Goetschi T,

1 The new WHO Health Economic Assessment Tool for Walking and Cycling - an introduction Francesca Racioppi, WHO Regional Office for Europe Sonja Kahlmeier, University of Zurich, EBPI, Physical Activity and Health Unit Rutter H, Cavill N, Schweizer C, Goetschi T, Kelly P, Castro-Fernandez A, Brand C, Rojas Rueda D, Woodcock J, Lieb C/Sommer H, Oja P, Foster C

Fiona Bull, Alberto Castro- Fernandez, Dushy Clarke, Andy Cope, Baas de Geus, Audrey de Nazelle, Ardine de Wit, Hywell Dinsdale, Rune Elvik, Mark Fenton, Jonas Finger, Francesco Forastiere, Richard

2 A collaborative project Harry Rutter, Francesca Racioppi, Sonja Kahlmeier, Thomas Götschi, Nick Cavill, Alberto Castro-Fernandez, Paul Kelly, Christian Brand, David Rojas Rueda, James Woodcock, Christoph Lieb/Heini Sommer, Pekka Oja, Charlie Foster Karim Abu-Omar, Lars Bo Andersen, Hugh Ross Anderson, Finn Berggren, Olivier Bode, Tegan Boehmer, Nils-Axel Braathen, Hana Bruhova- Foltynova, Fiona Bull, Alberto Castro- Fernandez, Dushy Clarke, Andy Cope, Baas de Geus, Audrey de Nazelle, Ardine de Wit, Hywell Dinsdale, Rune Elvik, Mark Fenton, Jonas Finger, Francesco Forastiere, Richard Fordham, Virginia Fuse, Eszter Füzeki, Frank George, Regine Gerike, Eva Gleissenberger, George Georgiadis, Anna Goodman, Maria Hagströmer, Mark Hamer, Eva Heinen, Thiago Herick de Sa, Marie-Eve Heroux, Max Herry, Gerard Hoek, Luc Int Panis, Nicole Iroz-Elardo, Meleckidzedeck Khayesi, Michal Krzyzanowski, I-Min Lee, Christoph Lieb, Brian Martin, Markus Maybach, Irina Mincheva Kovacheva, Hanns Mooshammer, Marie Murphy, Nanette Mutrie, Bhash Naidoo, Daisy Narayanan, Mark Nieuwenhuijsen, Åse Nossum, Laura Perez, Randy Rzewnicki, David Rojas Rueda, Gabe Rous - seau, Candace Rutt, Kjartan Saelensminde, Elin Sandberg, Alexander Santacreu, Lucinda Saun - ders, Daniel Sauter, Peter Schantz, Tom Schmid, Christoph Schreyer, Christian Schweizer, Peter Schnohr, Nino Sharashidze, Jan Sørensen, Joe Spadaro, Gregor Starc, Dave Stone, Marko Tainio, Robert Thaler, Miles Tight, Sylvia Titze, Wanda Wendel Vos, Paul Wilkinson, Mulugeta Yilma Software development and design: Tomasz Szreniawski, Alberto Castro Fernandez, Ali Abbas, Vicki Copley, Duy Dao Expertise involved: Epidemiology / Public Health Environmental Science Air pollution Health Economics Transport Economics Transport Planning Policy making Practice / Advocacy

3 For whom was HEAT originally developed? 53 Member States: Civil servants Staff supporting policy makers, Officers/experts locally responsible for transport and urban planning Large differences in: capacities data availability

4 HEAT core principles Scientific robustness Usability Minimal data input requirements Availability of default values Clarity of prompts/questions Design and flow of the tool Transparency Approach and assumptions Conservative Adaptable Modular

5 What is the HEAT? Online tool Designed for transport planners Economic assessment of health benefits of walking or cycling Effects on mortality only Evidence-based Transparent Adaptable

6 What can you use it for? Assessing current (or past) levels of cycling/walking What is walking/cycling worth now in my city, region, country? Assessing changes over time E.g. before after, scenario A vs. scenario B Evaluating new or existing projects, Value of health benefits of investments and benefit cost ratios

7 The question If x people walk/cycle an amount of y on most days, what is the economic value of the health benefits that occur as a result of the reduction in mortality due to their physical activity? New HEAT options - How much do air pollution or crashes affect these results? - What are the carbon effects?

Walking and/or cycling Impacts (Physical activity, air

Time and spatial scale Data inputs Volumes of travel

Population size Adjustment of data inputs New vs.

default values (Uptake period, trip/step length, speeds,

Physical activity benefit Reduced mortality risk from walking

of active mode Air pollution risk Mortality risk when walking

AP exposure Crash risk Mortality risk when cycling.

factors Reduced mortality/carbon emissions Aggregated Mode and

8 Basic functioning of the new HEAT 4.0 User inputs What do you want to assess? Walking and/or cycling Impacts (Physical activity, air pollution, crash risk, carbon emissions -> motorized modes) Time and spatial scale Data inputs Volumes of travel Duration/distance/trips/steps New: Frequency / Mode share/shift Population size Adjustment of data inputs New vs. reassigned Shifted from other modes (carbon) For transport or recreation (AP, carbon) In traffic vs. away from traffic (AP) Calculation parameters Changeable default values (Uptake period, trip/step length, speeds, mortality rate, air pollution level) Other background values Physical activity benefit Reduced mortality risk from walking and/or cycling 1 RR Local vol. of active mode Reference vol. of active mode Air pollution risk Mortality risk when walking and/or cycling 1 RR AP exposure of active mode users Reference AP exposure Crash risk Mortality risk when cycling. Countrywide fatal crashes Countrywide vol. of active mode Local vol. of active mode Carbon Reduction in emissions from substituting motorized modes Local vol. of active modes shifted from motorized modes carbon emission factors Reduced mortality/carbon emissions Aggregated Mode and pathway specific Monetization Value of statistical life (VSL ) or Social costs of carbon. (SCC) RR = relative risk of death in underlying studies (walking: 0.89 and cycling: 0.90). relative risk of death per 10 µg/m3 increase in PM2.5 in underlying studies (1.07) walking module work in progress

9 This project has received funding from the European Union s Seventh Framework Programme for research; technological development and demonstration under grant agreement no

10 Demo: the question If the adult population of Geneva cycled on average 10 minutes per day more, what is the economic value of the health benefits as a result of the reduction in mortality due to their physical activity (and increase in mortality due to air pollution and crash risk)? And what are the related carbon effects?

The new WHO Health Economic Assessment Tool for Walking and Cycling - a sneak preview

The new WHO Health Economic Assessment Tool for Walking and Cycling - a sneak preview Nick Cavill, University of Oxford, UK. Francesca Racioppi, WHO Regional Office for Europe; Sonja Kahlmeier, University