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Stage 1 ReportResearch and Review

For Health Promotion Queensland

May 2011

Cost and health benet of

active transport in Queensland

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Cost and Health Beneft o Active Transport in Queensland: Stage 1 Report: Research and Review

2

Project TeamMr Ian Ker

Chie Investigator

Transport Economics

Mr Elliot Fishman

Report Editor

Dr Jan Garrard

Health impacts o active transport initiatives

Mr Todd Litman

Transport and Health Economics

Proessor Chris Rissel

Peer Review

Contact

Elliot Fishman

T: +61 3 9489 7307

E: [email protected]

W: www.sensibletransport.org.au

PO Box 273 Fairfeld VIC 3078

Suggested citation: Fishman E., Garrard J., Ker I., Litman

T., 2011Cost and Health Beneft o Active Transport in

Queensland: Research and Review, Stage One Report.

Prepared by CATALYST or Health Promotion Queensland.

Design and Layout

merrycreativemc

www.merrycreative.com.au

Mr Elliot Fishman

Report Editor

Mr Ian KerChei Investigator

Transport Economics

2011


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Cost and Health Benet o Active Transport in Queensland: Stage 1 Report: Research and Review

4

Transport, Health and Public Policy

This section outlines where active transport sits in public policy decision-making and

articulates the key reasons it sometimes all o the policy agenda. The variety o co-

benets o active transport are spread across the health, environment and transport

portolios (see Figure 2) and this has meant walking and cycling have ound it difcult to

nd a home, with detrimental impacts in terms o government investment. The benets

o active transport are spread across a range o sectors and there is considerable synergybetween the outcomes originating rom investment in walking and cycling (see Table 3).

The co-benets o active transport have begun to receive recognition in government

strategies, with walking and cycling explicitly and implicitly recognised as helping to support

national and/or state targets in a range o public policy sectors. The ollowing strategies have

been summarised or their relevance to active transport in this report (see Section 2.5):

NationalCyclingStrategy20112016

QueenslandCycleStrategy

TowardQ2ExecutiveSumma

ry

SouthEastQueenslandRegionalPlan20092031

Blueprint foranActiveAustralia

Active,HealthyCommunities

AnAustralianVisionforActiveTransport

HealthySpacesandPlaces

QueenslandChiefHealthOcersReport:TheHealthofQueenslanders2010

Each o the above strategies highlight the important role walking and cycling can play in

meeting the uture needs o Queenslanders, whether it be in improved health outcomes,

greater transport efciency, reduced greenhouse gas emissions or community liveability

benets. The level o prominence active transport occupies in the strategies listed above

signies a step change or walking and cycling in both national and state contexts,

including Queensland. One o the central themes in the documents identied above is

that many o the major gains in population health can be made through reorms outside

the health sector.

Evaluation in Public Sector Decision-Making

This component o the report provides an overview and critical analysis o the methods

employed to evaluate public policy. It nds that evaluation is usually restricted to

individual projects or programs, rather than society- or economy-wide analysis. This

section describes the difculties associated with public sector evaluation, such as the

way in which dierent policies interact with each other, making the eects o individual

programs difcult to isolate.

Evaluation o active transport policies and programs can be constrained by:

theperceivedneedtocontinueexistingprograms

politicalcommitmentsthatmayconictwithaproposednewinitiative.

In relation to active transport, the public policy ocus has been on transport and

environmental consequenceswith less attention given to health and social outcomes.

Even when health is a ocus, short-term imperatives such as hospital waiting lists can be

prioritised over longer term, population health outcomes related to prevention.

Transport evaluations have typically ailed to take into account the ageing o the

population and the changes in driving patterns likely to ollow this demographic shit.

Currently some 14% o the Australian population are over 65 years (increasing to 25% in

2050) and, as these older age groups cease driving, the demands on our transport system

Creating a supportive environment can encourage walking

Cost and Health Beneft o Active Transport in Queensland: Stage 1 Report: Research and Reviewii


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will alter signicantly. Transport planning will need to become more responsive to this

demographic step change.

Active transport has in some cases been the victim o reductionist public policy. When

problems are assigned to individual agencies, with narrowly dened responsibilities,

walking and cycling (with their wider range o co-benets) can oten be disadvantaged.

For example, transport agencies can rationally expand roads to reduce congestion,

even i this degrades walking and cycling conditions (and thereore reduces population

levels o physical activity). Similarly, environmental agencies can implement ueleciency standards that, by reducing the per-kilometre cost o driving, stimulate more

car travel and thereore more congestion and accidents. These agencies run the risk o

undervaluing walking and c ycling improvements.

By developing a comprehensive method o evaluating public policy decisions, win-win

strategies can be identied that provide a solution to one problem that also helps reduce

other challenges acing society, such as congestion reduction strategies that also help

reduce parking costs, improve mobility options or non-drivers and increase physical

activity and health.

STRATEGY

P lan ni ng Ob je ct ive R oadw ay Exp an si on Fue l Ec ie nt Veh ic le s Impr ove d Tr an spo rtOptions, Ecient

Pricing, Smart Growth

Motor Vehicle Travel Impacts Increased Increased Reduced

Congestion reductionp/X X p

Road and parking cost savings X X p

Consumer cost savingsp/X p/X p

Reduced trac accidents X X p

Improved mobility options X X p

Energy conservation X p p

Pollution reduction X p p

Smart growth land useobjectives

X X p

Physical tness & health X X p

The introduction o sustainability into evaluation procedures has helped capture the

environmental impacts o initiatives designed to boost levels o walking and cycling. This

haslargelyfailed,however,toreectthesocialimpactsoftransportandlanduseprojects.

Discount rates are typically used to discount uture benets when undertaking benet-

cost analysis and this is oten at odds with sustainability (which is essentially about

valuing the uture). Active transport enhances the triple bottom line by delivering

measurable outcomes o three kinds:

1. enhancing and sustaining economic prosperity

2. sustaining and protecting the natural and built environment

3. enhancing social outcomes, including access opportunities or people who

are currently mobility-poor.

Health benets rom active transport can be accounted or under both the economic

and social categories. Every part o this triple bottom line will also be enhanced by the

positive health efects that arise rom active transport and the regular physical activity it

entails.

Transport has signicant nancial costs to households. On average, some 16% o

household expenditure is transport relatedcomparable to housing or ood. It is widely

expected that motorised transport costs will continue to rise and this is likely to resultin less money available to other sectors o the economy. Active transport ofers the

opportunity to lower household expenditure on transport, thereby enhancing more

employment intensive sectors o the Queensland economy.

The two key requirements or evaluating active transport initiatives are to be able to:

1. Quantiy the change in travel activity (increased walking and cycling, reduced

driving) that is likely to come about as a result o the initiative. This level

o evaluation is dealt with in Sec tion 6.

2. Translate the behaviour change into estimates o those things that are o

value to the community, such as improved health, lower transport costs

and better environmental outcomes. This level o evaluation is dealt with in

Section 6 and 7.

Comparing Strategies

*

Motor Vehicle Travel Impacts Increased Increased Reduced

ExecutiveSumma

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ExecutiveSumma

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NB: Some transport improvement strategies only achieve one or two objectives ( ), and by

increasing total vehicle travel contradict others (x). Strategies that improve alternative modes;apply more ecient road, parking, insurance and uel pricing; and create more compact, mixed

land use help achieve many objectives.

*Whilst roadway expansion reduces congestion initially, similar levels o congestion return due to

induced trac (Newman & Kenworthy, 1999).

Comparing Strategies

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STUDY OR TOOL DESCRIPTION ANALYSIS SCOPE ANALYSIS METHODOLOGY STRENGTHS WEAKNESSES

ICLEI Active TransportQuantication Tool (ICLEI,2007)

Estimates the health,community andenvironmental benets o

walking or cycling.

Includes user costsavings, reducedmortality and reduced

pollution.

User-specied changes in active transportor each o ve types:

walking school bus

walk to school

ride to school

walk to workride to work

Available at no cost as an online tool.

Straightorward to use.

Incompleteforevaluationpurposes.Onlyconsiderssomebenetcategories.Health eects limited to:

mmortality, not morbidity

mtype 2 diabetes and coronary heart disease.

Mixesnancialandeconomicvalueslimitedsuitability or benet-cost analysis.

World Health Organisation:

Health EconomicAssessment Tool (Cavill etal, 2007)

Evaluates health benets

o cycling

H ea lt h be ne ts Q uan ti es m on et is ed va lue o h ea lt h

benets rom a specic increase in cycling bya specic population.

Availableatnocostasanonlinetool.

Straightforwardtouse.

Basedonbestcurrentinformationoncycling health impacts.

Incompleteforevaluationpurposes.

Onlyconsiderscycling,notwalking.

Healtheectslimitedtomortality(doesnot

include morbidity).

BasedonEuropeanconditions.

Victorian and Australian

Greenhouse OfceWorkplace Travel Planning

Benets Calculator (Ker& Sidebottom, 2004;

Sidebottom, 2005)

Provides indicative

estimates o the benetso workplace travel

planning (WTP). Designedas a demonstration tool to

interest businesses in WTP.

Identies benets to

employees, employersand the community,

including health benets.

Research-based estimates o travel outcomes

o workplace travel planning in user-denedsituations coupled with benet values

derived rom Australian and internationalresearch.

Straightforwardtouse.

Allowsusertospecifysituationfor

analysis.

Incompleteforevaluationpurposes.


include morbidity).

Walkingbasedoncyclingresearch.

Valuesandalgorithmsarelockedandcannotbe

modied or updated by the user.Evaluating Non-MotorisedTransport Benets and Costs

(Litman, 2010)

Identies variouscategories o non-

motorised transportbenets and costs.

Broad range o benetsand costs.

Comprehensive ramework or evaluatingnon-motorised transport benets and costs,

including saety and health impacts.

Comprehensive.Denesvariousimpactsand

describes methods or quantiying andmonetising them.

Provides limited detail on each impact.Methodologies and estimates are mainly based

on other sources.

UK Transport AnalysisGuidance (Departemnet or

Transport, 2010a)

Provides ofcial guidanceor evaluation o walking

and cycling schemes.

Broad range o benetsand costs, including

externalities and healtheects.

Applies conventional benet-cost analysisramework to the outcomes o walking and

cycling initiatives.

Incorporates additional actors, includinghealth benets, absenteeism, environmentalbenets and journey ambience.

Methodologyandvaluesintegratedwith the overall guidance on appraisal

o transport initiatives (DT, 2010b) andconsistent with Treasury requirements

or project appraisal (DT, 2010c).

Health eects limited to mortality (does notinclude morbidity).

Does not deal with behaviour change initiatives

as such, although the guidance is likely to betranserrable.

Evaluation Tools and MethodologiesEvaluation tools or active transport are o two main types:

1. generic tools that assist in making indicative estimates o the benets o active

transport without reerence to specic programs, projects or spatial contexts

2. specic methodological tools that provide a robust assessment rameworkcomparable to those used or other public sector initiatives. These enable

comparison between projects and programs in the public sector.

The ollowing matrix provides a summary, including critical analysis o the best s tudies

and tools used to quantiy and monetise the benets o active transport:

Benet-cost analysis, supplemented by some

orm o goals achievement matrix, is themost appropriate way o evaluating activetransport initiatives.

Continued over page ExecutiveSumma

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ExecutiveSumma

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Cost and Health Benet o Active Transport in Queensland: Stage 1 Report: Research and Review

7

ExecutiveSumma

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New Zealand Economic

Evaluation Manual (LandTransport New Zealand,

2006)

Provides ocial guidance

or evaluation o traveldemand management

and o walking and cyclingschemes.

Broad range o benets

and costs, includingexternalities and health

efects.

Applies conventional benet-cost analysis

ramework to the outcomes o traveldemand management, walking and cycling

initiatives.

Methodologyandvaluesintegrated

with the overall guidance on appraisalo transport initiatives (LTNZ, 2006).

Providesseparatevaluesforwalkingand cycling.


include morbidity).

Doesnotdealwithbehaviourchangeinitiativesas such, although the guidance is likely to betranserrable.

Researchbasisfordierentwalkingandcycling

values not demonstrated.Applying Health ImpactAssessment To LandTransport Planning (New

Zealand Transport Agency,2009)

Provides guidance orhealth impact assessment(HIA) in transport planning

Transport planning. Onlyconsiders health impacts(no other benets o non-

motorised transport

Describes and reviews the scope andmethods used or Health Impact Assesment.

Discussesbestcurrentpracticesforevaluating health impacts.Recommends comprehensive

evaluation o health impacts.Recommends incorporating health

impacts into comprehensive benet/cost analysis

Onlyprovidesgeneralguidance.Doesnotinclude specic monetised values.

The Hidden Health Costs oTransportation (AmericanPublic Health Association,

2010)

Estimates the costs oautomobile-dependenttransport

Includes monetisedestimates o obesity, airpollution and accidents

Uses unit costs or obesity, air pollutionand crash costs rom previously publishedliterature (Fincklestein et al, 2009; Federal

Highway Administration, 2000; AAA, 2008).

Quantiesandmonetisesthreemajorrisks.

Onlyprovidestotalcosts.Oerslittledetailorguidance or applying cost values to a particularsituation.

Walking, Urban Design, andHealth: Toward a Cost-

Benet Analysis Framework(Boarnet, Greenwald and

McMillan, 2008)

Provides monetisedestimate o physical

activity benets

Develops a rameworkor valuing the health

benets o urban designimprovements that

increase walking activity.

Estimates benets o improvingneighbourhood walkability rom the 50th

percentile to the 75th percentile (lowervalue) and the 95th percentile (higher

value), or a hypothetical 5000-residentneighbourhood.

Providesquantiedvaluesofincreased walking.

Incorporatesmanyassumptionsthatmaynotbe transerable to other situations.

Onlyconsiderscertainhealthbenets.

Cost-Efectiveness oInterventions to Promote

Physical Activity (Cobiac, Vosand Barendregt, 2009)

Models the cost impactsand health outcomes

o six physical activityinterventions in Australia.

Health benets o specicprograms.

Assigns dollar values to various programsthat increase disability-adjusted lie years

(DALYs).

Providesspecicdollarvaluestospecic programs

Focusesonprograms,nottransportpolicychanges.

Usesstandardvalues.

Household TravelSmart

evaluations (Ker and James,2000; Ker, 2004, 2008a; Ker

and Ringvall, 2006)

Evaluates benets and

costs o IndiMark inWestern Australia and

Queensland

Broad range o benets

and costs, includingexternalities and health

efects.

Applies conventional benet-cost analysis

ramework to the outcomes o travelbehaviour change initiatives. Values or

benets derived rom international research,except:

congestion (based on BTRE, 2007)

climate change.

Methodologyconsistentwithnational

(ATC, 2006) and Queensland (DIP, 2010)transport appraisal guidelines.

Benetvaluescanbeupdatedandrange o values extended on the basis o

external evidence.

Allowsalternativebenetvaluestobeappliede.g.wherevaluesdierbetweentimes and places (such as congestion).

Facilitatessensitivityanalysisthrough

application o ranges or any item o costor benet.

Methodologyandvaluesaretransferabletoothercontextse.g.cycling

inrastructure (Ker, 2009b) and schoolactive travel (Ker, 2006).

Benetvaluesmaynotbetransferrable

between situations and places.

Healtheectslimitedtomortality(doesnotinclude morbidity).

Table 5: Summary o the major studies to quantiy and monetise the benefts o active transport

STUDY OR TOOL DESCRIPTION ANALYSIS SCOPE ANALYSIS METHODOLOGY STRENGTHS WEAKNESSES

Continued rom previous page

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The World Health Organisations health economic assessment tool (HEAT) has been

incorporated in the UK Department or Transport appraisal standards and Land Transport

New Zealands economic evaluation tool is widely used to assess the benet-cost ratio or

active transport projects and is generally well accepted by practitioners working in the

sector.

Benet-cost analysis (BCA) is described, in relation to the evaluation o active transport, as

a means o comparing the costs and impacts o proposed projects. A limitation o BCA is

that it is restricted to measuring those impacts that can reasonably be given a monetary

value. In general terms:

Economicimpactsareusuallyobservableasamonetaryvalueandtherefore

relatively straightorward to include in BCA.

Environmentalimpactsoftenhaveestimatedmonetaryvalues,butthesehave

limitations as the observed trade-ofs are usually based on imperect

inormation, especially with regard to long-term issues.

Socialimpactsrarelyhaveestimatedmonetaryvalues.

Social issues, including health, are relatively recent additions to the transport evaluationparadigm and there is subsequently a much smaller body o evidence on which to base

benet-cost evaluations. See Section 4.31 regarding benets not included in BCA.

The literature review ound that almost all attempts at developing BCA tools or active

transport are based on mortality and ail to account or morbidity and well-being

impacts.The streets connecting communities to schools are critical in determining the level of education-based active transport

Cost and Health Beneft o Active Transport in Queensland: Stage 1 Report: Research and Reviewvi



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Health Impacts o Active Transport: Summary o Evidence

Active transport has signicant population health benets in both the child and adult

population. Chie among them are the numerous health impacts associated with

increased physical activity. When increases in active transport are also associated with

reduced motor vehicle travel, additional benets accrue rom improved air quality,reduced noise pollution, greenhouse gas abatement and enhanced community liveability

(see Table 6).

Good evidence has been ound to demonstrate:

Cyclingtoschoolincreasesaerobictness.

Activetransporttoschooldoesnotreplaceotherformsofphysicalactivity.

Aerobictnessincreasesintelligencequotient,cognitivefunctionand

educational attainment.

A considerable proportion o the Queensland population do not participate in sufcient

levels o physical activity to protect against sedentary liestyle disease. Active transport

levels in Australia are low compared to the best perorming OECD countries. Althoughsome trips are beyond a reasonable walking or cycling distance, a majority o Queensland

car trips are less than 5 km, indicating considerable scope or greater levels o physical

activitythroughactivetransport(seeFigures79).

In Queensland, insufcient physical activity is the third largest single determinant on

the Burden o Disease scale and 62.7% o males and 50.6% o emales are overweight or

obese. This is expected to double by 2025. A survey o young people in Queensland in

2006 ound that 27% o boys and 42% o girls in Year 1 achieved an adequate number o

steps per day. In Year 5, this increases to 40% o boys and 53% o girls.

Public transport is also a signicant generator o walking trips. For South East

Queensland, whole single-mode walking trips are longer than the walking trip stages

made to and rom public transport, both in terms o distance and time. However there

are more than twice as many walking trip stages to and rom public transport as there are

single-mode walking trips. This indicates that active transport polices, when integrated

closely with the public transport system, are likely to signicantly increase population

levels o walking or transport.

Active transport has also been ound to reach population groups less likely to participate

in leisure-time physical activity. While socioeconomically disadvantaged population

groups are about twice as likely as less disadvantaged groups to participate in leisure-

time physical activity or sports, the reverse relationship is oten observed in active

transport. Increasing the population prevalence o active transport in Queensland may

thereore contribute to reducing health

inequalities.

It is now widely acknowledged that the

implementation o structured exercise

programs and sports participation

is unlikely to provide substantial

improvements in the high and inequitably

distributed health burden associated

with low levels o physical activity in

Queensland. The emphasis is now on

ostering active living by building regular

activity into daily lie.

Saety is a key issue related to active transport and whilst absolute levels o risk are low

internationally, relative risk, based on trafc exposure, is generally higher or walking

and cycling than or car travel. Even in the current trafc environments in the United

States and New Zealand, one atality occurs or approximately 10 million k ilometres

walked or cycled. In countries with high levels o active transport this gure decreasesto one atality or approximately 100 million kilometres travelled. The considerable

variation shown here suggests that much can be done to increase current levels o

saety or pedestrians and cyclists. Research also shows the perception o ear is oten

disproportionate to actual levels o risk and this culminates in a ear o cycling mentality

in countries with low levels o cycling (see Figure 18). A number o studies have ound the

health benets o cycling outweigh the health risks associated with potential injury.

New research has also discovered particular health benets associated with exercising

while in contact with the outdoor environment. So-called green exercise has been

ound to improve sel-esteem and mood. Whilst these studies have not looked at active

transport specically, walking and cycling or transport almost always occur outdoors and

these benets are thereore likely to hold true or active transport.

Australian studies on the impacts o motor vehicle use have revealed an associationbetween driving to work and obesity, with drivers 13% more likely to be overweight or

obese, even ater controlling or leisure-time physical activity and other conounders.

Similar associations between time spent driving and obesity have been ound

internationally, including China and the United States.

The health benets ocycling outweigh the

health risks associatedwith potential injury.

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The Extent o Change in Active Transport: Intervention Types

and Evaluation Approaches

A range o interventions aimed at increasing levels o active transport have been

evaluated or their efectiveness. The diferent orms o interventions have been

categorised into our domains, as outlined below:

Individually ocused behaviour change programs and active transport inrastructure have

been investigated most thoroughly in the literaturewith some research addressing

both. Few studies have evaluated policy/regulatory interventions and it appears no

interventions have been evaluated ocusing primarily on social/cultural actors.

Determiningwhatinfuencesactivetransportisacomplextaskthatrequirestheanalyst

to consider a multitude o actors, oten whilst aced with a lack o data. At the personal

level, the decision to use active transport involves weighing up (oten implicitly) the

perceived benets and barriers o both the target behaviour (active transport) and the

competing behaviour (driving).

Interventions have been categorised,

where appropriate, into the commonly

used settings o schools, workplaces and

communities. A number o reviews o

school-based interventions have been

summarised in Table 11. Recent studiescritically evaluated include:

Ride2Schoolprogram(Victor ia)

ActiveSchoolTravelProgram

(Brisbane)

AucklandSchoolTravelPlans

To summarise, considerable variation occurs both between these programs and even

between individual schools running the same program. Much o this evaluation literature

is relatively recent, and there has been little systematic assessment o the reasons or

variable program impacts. However, based on limited process/implementation evaluation

data to date, the determinants o success are likely to include actors associated withschools, their social, cultural and built environments; program type; and quality o

programs implemented. Evaluation designs and methods also impact on evaluation

ndings.

Community-based interventions have been summarised and are included in Table 12,

with workplace interventions contained in Table 13. Interventions to increase active

transport in countries such as Australia are relatively recent, and evaluation ndings

point to considerable variability in program impacts both between programs and

within individual settings in multi-site programs. Consequently, it is unlikely that a

one size ts all approach will result in substantial and sustained increase in active

transport and there is much to learn about what works or whom in which settings.

Programmatic interventions also need to be nested within an overall strategy that

includes an integrated package o programs and supportive policies. Evidence in areassuch as tobacco control, road saety and childhood immunisation indicates that return

on investment in comprehensive public health strategies can be substantial or both

government and society.

ExecutiveSumma

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Healthy citizens arethe greatest asset any

country can have.Winston Churchill

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o

o

Physical environment

(natural and built)

Social, culturalenvironment

Intra-individual actors Travel behaviour

Policy/regulatory

environment

Determinants of travel modesDeterminants o travel modes

Cost and Health Beneft o Active Transport in Queensland: Stage 1 Report: Research and Reviewviii



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IMPACT CATEGORY DESCRIPTION

Direct User Benefts Benefts rom improved walking and cycling conditions

Benets to users Increased convenience, comort and saety to walkers and bicyclists.

Option value and emergency response Increased mobility options, in case they are ever needed, including the ability to evacuate and deliver resources during

emergencies.

Improved accessibility Increased level and types o access to valuable services and activities such as education, employment, healthcare andshopping.

Equity Improved accessibility or economically, socially or physically disadvantaged people.

More Active Transpor t Beneft s rom increased walking and cycling a ct ivit y

Fitness and health benets Improved physical tness and health as a result o increased walking and cycling activity.

Reduced Vehicle Tra vel Beneft s rom reduced motor vehicle ownership and use

C on ge st ion redu ct ion R educ ed tr ac c on ge st ion ro m au tom obi le tr ave l on co nge st ed ro ad ways.

Reduced barrier efect Improved non-motorised travel conditions due to reduced trac speeds and volumes.

Vehicle cost savings Reduced consumer costs rom vehicle ownership and use.

Avoi ded cha ufe ur in g R educ ed ch auf eu ri ng re spo ns ibi li ti es du e t o i mpr oved tr ave l op ti on s.

R oa dwa y c os t s av ing s R educ ed r oa dwa y c on st ru ct io n, m ai nt ena nc e a nd o pe ra ti ng c os ts .

Parking cost savings Reduced parking problems and acility cost savings.

Ene rg y c on ser vat ion Inc re as ed ec on om ic an d en vi ron men ta l be ne ts r om red uc ed en erg y c on sum pt ion .

Pollution reductions Increased economic and environmental benets rom reduced air, noise and water pollution.

Land Use Impacts Benefts rom more walkable land use development

Transpor tation land Reduced land area required or roads and park ing acilities.

Ecient land use development More ecient land use, such as more compact, mixed, multi-modal development, which increases overall accessibility andreduces sprawl.

Property value increases Increased local property values due to improved walking and cycling conditions (capitalised value o perceived uture userbenets).

Eco no mic D ev el opm en t B en ef ts ro m in cr ea sed pr odu ct iv it y a nd emp loy men t

Support or specic industries Increased support or specic industries, particularly retail and tourism, as a result o improved walking and cyclingconditions (e.g. streetscaping, walking and cycling paths etc.).

Increased productivity Increased productivity and reduced costs to governments and businesses as a result o transport-related savings

(i.e. reduced congestion, parking, consumer, healthcare and energy costs).

Valuing the Impacts o Change in Active Transport

The benets associated with active transport have been categorised in the table below

and described in urther in Section 7.

The benets identied in the table varysignicantly depending on the particular

context in which they occur. For instance,

an isolated stretch o bicycle path will

provide only modest benet, but the same

stretch integrated into a comprehensive

network o active transport inrastructure

will give a considerably greater return.

The monetised benets to health rom

active transport have been quantied

in a number o studies and these have

been summarised in Table 17. The value

per additional cyclist ranges rom 22 to498 and depends on a number o actors,

including the age o the cyclist.

ExecutiveSumma

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ExecutiveSumma

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A summary o potential walking and cycling benefts

Cost and Health Beneft o Active Transport in Queensland: Stage 1 Report: Research and Reviewix



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Costs o Active Transport

The benets o increased active transport described in this report have costs associatedwith them. These costs come in the orm o acility construction costs and additionaltravel time, although active transport was ound to be surprisingly time-competitive with

motorised transport over distances less than 5 k m in congested, urban areas.

MEASURE TYPICAL COSTS

On road bike lanes* $200,000 per kilometre (both sides o street)

Bicycle parking $300 per bicycle rack (parks two bikes)

Zebra crossing* $5000 ($10 000 when requiring electrical connection)

Three metre wide shared path* $600 000 per kilometre

Speed table (bicycle riendly)* $10 000 per unit

Typical acility costs

*Actual fgures will vary considerably depending on local conditions and construction costs

The Economic Basis o Benet-Cost Analysis

Transport policy and planning decisions have many impacts, including some that afectnon-market goodsthat is, goods not generally bought and sold in a competitivemarket, such as personal time, saety, health, and environmental quality. For example,

a transport agency may ace a decision that requires a trade-of between improvedsaety and environmental protection and so must make judgments about the value thatpeople would place on these goods. One approach to this type o analysis is to monetise(measure in monetary values) such impacts.

Transport economists have extensive experience monetising non-market goods,including incremental changes in travel time, accident risk and environmental values.

Some o the techniques they use are described in Section 9 and include:

damagecosts

hedonicmethods(alsocalledrevealedpreference)

contingentvaluation(alsocalledstatedpreference)

controlorpreventioncosts compensationrates

travelcostmethod.

The methodology used to determine the economic value o a particular transport policyor planning decision is illustrated in the table below. This table summarises the various

steps to be considered and the inormation needed to analyse each step in order toevaluate policies and planning decisions that afect active transport activity.

ExecutiveSumma

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The cost o bicycle inrastructure is outweighed by its benefts, in terms o health, the environment andcongestion reduction

The methodology used to determine the economic value o a particular transport

policy or planning decision is illustrated in the table on the ollowing page. This table

summarises the various steps to be considered and the inormation needed to analyse

each step in order to evaluate policies and planning decisions that afect active transport

activity.

Cost and Health Beneft o Active Transport in Queensland: Stage 1 Report: Research and Reviewx



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STEPS FROM DECISIONS TO ECONOMIC

VALUATION

INFORMATION REQUIREMENTS

Public Policy And Planning Decisions(inrastructure unding and pricing, acility design, acility

management, land use development, encouragement programs, etc.)

Types o policy and planning decisions (including innovative and indirect strategies such as pricing reorms and changes in land use development patterns),their design, duration, integration (with other transport and land use policies), level o community support, and responsiveness to user demands.

Change in Travel Conditions(better ootpaths, shared paths and bike lanes, higher ees or

driving, slower motor vehicle trac, closer destination, etc.)

Multi-modal evaluation which measures the relative quality o travel by diferent modes under particular conditions. For example, walking and cycling level-o-service rating which indicate the quality o walking and cycling conditions and how they would be improved by a particular policy or project.

Changes In Travel Activity

(less driving, more walking and c ycling, more ridesharing, more

public transport use, more reliance on local services which reducesaverage trip distances, etc.)

Multi-modal transport modelling that can accurately predict how specic changes in walking and cycling conditions (including the quality o non-motorised acilities, roadway design, trac volumes and speeds, transport pricing, and land use patterns) will afect the use o active modes. This should

be disaggregated by demographic actors (who would change their travel activity) and trip type (what types o travel would change, such as commuting,errands, recreation, etc.).

Land Use Changes

(less land devoted to roads and parking acilities, more compact,mixed, connected development)

Integrated transport and land use modelling that indicates how changes in travel conditions and activity afect development patterns. This should include

analysis o demand or more walkable and bikeable locations.

Transport Impacts(changes in trac congestion, consumer time and money costs,

road and parking acility costs, accident rates, emissions, physicalactivity and health, mobility or non-drivers, etc.)

Quantiy various impacts o travel activity changes, including congestion delays, acility costs, user t ime and nancial costs, accidents, emissions, physicalactivity and health, accessibility and afordability or disadvantaged people, etc. Since public health is particularly important or this project, special attention

should be given to health-related impacts. This should be disaggregated by demographic actors (identiy who benets).

Economic Valuation

(nancial costs to consumers, businesses and governments,monetised value o changes in health and travel time, sum o allmonetised values)

Apply various accounting and monetisation techniques to calculate the dollar value o various benets and costs. Since public health is particularly

important or this project this will include monetisation o trac accidents, vehicle pollution, physical tness and related health benets, and (i appropriate)mental health impacts.

Optimisation

(determine what policies and planning options are most costefective)

Create a model that allows various policies and planning options to be tested to determine which provide the greatest net benets, considering all impacts.

ExecutiveSumma

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Evaluation Framework

Cost and Health Beneft o Active Transport in Queensland: Stage 1 Report: Research and Reviewxi



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Active Transport Evaluations

The monitoring and evaluation o active transport programs have a mixed record, with

household/community social marketing programs like TravelSmart having had the

greatest exposure to ormal evaluation. This section evaluates a number o individual

behaviour change programs taking place at the school, household and workplace setting.In addition, meta-evaluations have been analysed and generally show a consistent

pattern o results that demonstrate the positive changes in active travel stemming rom

behaviour change programs. In general, the programs that have the strongest benet-

cost ratio are those that include a multiaceted approach to active transport promotion.

Adequacy o Active Transport Evaluations

Active transport and travel-behaviour change evaluations, including generic tools

developed to support ormal and inormal evaluation, have supported the validity

o benet-cost analysis as an appropriate evaluation methodology. The returns on

investmentowingfromactivetransportinitiativestypicallyoutperformconventional

motorised transport projects. Socioeconomic benet-cost analysis, i calibrated toappropriately capture the range o benets aorded to active transport, is likely to be

an eective tool to use in the evaluation o large-scale active transport proposals. The

health impacts o active transport are a problematic area o evaluation or three principal

reasons:

1. Estimation and quantication o the eects o active transport initiatives on

walking and cycling participation can prove difcult.

2. Identication and quantication o the health eects resulting rom the

changes in active travel are not straightorward.

3. Valuation o the health eects resulting rom the changes in active travel,

beyond the relatively simplistic valuation o mortality eects is a highly

specialised eld.

Recommendations or Further Research

In reviewing the current state o knowledge and practice o active transport, with

particular reerence to the health benets, it has become clear that there are substantial

deciencies that could be overcome (or at least ameliorated) through urther research.

In the area o active transport and health:

1. Better inormation is needed on the eects o active transport on health o

dierent age groups, especially or children, and the extent to which physical

activity (including active transport) in childhood carries over into later lie,

both in terms o physical activity levels and residual health benets.

2. Greater understanding is needed o the time period or benets to become

apparent and to achieve their maximum potential. This is likely to vary (a)

between the various diseases that are exacerbated by inadequate physical

activity and (b) the age group targeted by the active transport intervention.

3. Improved inormation is needed on the short- and long-term health eects

o walking in active transport initiatives, especially or primary school

interventions.

4. Australian-specic research is needed to evaluate the incremental change in

accident and health risk o specic policies and programs that aect walking

and cycling activity, taking into account direct user (walkers and cyclists)

risk per kilometre o travel, saety in numbers eect, changes in total travel

activity, risk to other road users, and possible risk reduction strategies.

Many o the benets beyond health are well established in evaluation o transport

projects, but emerging areas are less well served:

5. Better inormation is required on the quality-o-lie benets o active

transport, including (a) how to identiy, measure and quantiy them and

(b) how to place a socioeconomic value on them or benet-cost analysis

purposes.

6. In the absence o (b) above, an evaluation ramework capable o

incorporating non-monetary (either quantitative or qualitative) values should

be developed to demonstrate the existence, direction and, where possible,

extent o the quality-o-lie eects o active transport.7. More research is required to identiy the other social benets o active

transport in schools, including improved learning outcomes and enhanced

independence.

8. Better understanding is needed o the durability o the eects o active travel

programs, especially those aimed at school children. Lie-stage transition,

including between primary and high school, have impacts on capabilities,

travel needs and opportunities that could diminish or enhance the eects o

programs in primary school.

ExecutiveSumma

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1.

Cost and Health Beneft o Active Transport in Queensland: Stage 1 Report: Research and Reviewxii



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In relation to active transport more generally, in the context o transport planning and

sustainability:

9. Standard denitions and questions to include in travel surveys should

be established to collect better inormation on active transport demand

and activity. Current practices are ragmented and non-uniorm, making

it dicult to accurately compare transport patterns across diferent

jurisdictions, or even the same jurisdiction over time.

Travel surveys should be designed to collect better inormation on short

trips, travel by children, walking and cycling links o motorised trips as well

as more detailed user inormation, such as peoples physical ability and

health, incomes, vehicle access, and perceptions o walking and c ycling

conditions.

Travel survey data should report the amount o time spent travelling by

various modes. In addition, travel surveys should be coordinated with public

health studies to allow research on the relationships between transport

conditions, active transport, emissions, and health outcomes such as road

trac injuries, body weight, diabetes, and cardiovascular diseases. Federalor state governments, or proessional organisations should work to establish

standard travel survey questions to ensure consistency.

10. Targeted research is required to develop new models and improve existing

transport models to better predict how specic policy changes and projects

afect active travel activity. This research must include the impact on active

transport o improvements to motorised transport inrastructure. O special

importance is the need to investigate latent demand or active transport.

11. Additional research is needed to better understand how changes in active

transport afects motorised travel, including substitution rates and leverage

efects, and the types o motorised travel reduced, such as urban-peak

vehicle travel (which reduces trac congestion) and driving by young males(which reduces crash risk). It would be helpul to analyse leverage efects

using Australian data.

End of trip facilities such as this one at Royal Brisbane Hospital helps make cycling a more attractive commuting option

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Human powered transport holds a wide range o co-benefts that have previously been overlooked

-

This is the frst o two reports that will be delivered as part o this project. This report reviews:

evaluation principles and practice

the process of public policy decision-making

active transport costs and benets, including a critique of valuation and modelling methods

impacts of previous active transport encouragement programs

monetised costs and benets of transport modes, with a particular focus on active transport.

Stage Two of the project will be delivered in the second report.

Figure 1 below outlines stages one and two of the project.

1 IntroductionActive transport refers to walking, cycling and other forms of human-powered mobility.

Walking and cycling for transport oer a range of public policy benets in terms of

population health, greenhouse gas emissions, congestion relief and urban liveability. In

the last three decades, rates of walking and cyclingparticularly among school-agedchildrenhave reduced signicantly. Some seven out of 10 Queensland adults exercise

very little or not at all (Queensland Government, 2008, p. 32). This is considerably more

than the national average.

Walking and cycling have untapped potential to reverse this worrying trend towards

sedentary lifestyles and chronic disease. However, conventional transport planning tends

to undervalue non-motorised transport, in part because these health benets are not

considered in the economic evaluation of transport policies and projects. To address this

problem it is important to develop practical tools for more comprehensive evaluation of

active transport benets, including public tness and health benets.

Any evaluations that fail to appreciate the co-benets of active transport will signicantly

understate the value to the community of active transport programs and may hinder the

widespread adoption of eective active transport programs.

The aim of this project is to develop a comprehensive, accurate and practical framework

for evaluating the full benets and costs of active transport. This includes monetised

estimates of health benets, as well as other economic, social and environmental

outcomes, based on existing research and calibrated to the Queensland context.

Benet-CostEvaluation

Framework

Inormation Requirements

and Management

Designing an Appropriate Evaluation Model or Demonstrating

the Value o Active Transport Initiatives

Health Efects oActive Transport

Initiatives: values

Efects o Active

Transport Initiativeson Travel: values

Valuing the HealthEfects: Methods and

Values

Active Transport

EvaluationExperience:

Methods andOutcomes

Valuing the

Transport Efects:Methods and Values

Public Policy andEvaluation

Business Case or Active

Transport in Queensland

Recommended InvestmentLevel or Active Transport in

Queensland

Stage

One

StageTwo

This project will provide Queensland Healthand the Queensland Government more

broadlywith the information and tools to support public policy decisions that will

enable active travel programs to become an eective part of the public policy mix,

resulting in more desirable outcomes in a broad range of areas, including health,

transport and the environment.

Figure 1: Project overview

Cost and Health Beneft o Active Transport in Queensland: Stage 1 Report: Research and Review1


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Transport,Health and

Public Policy

2


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2. Transport, Health and Public PolicyThe multiplicity o agencies involved in strategic transport planning and related land use planning

can inhibit the resolution o long-term issues, not only because o diferent agency objectives but

also because resources to tackle the issues can be ragmented. there appears to be scope orsome resolution o roles within the existing organizational structure and or more efective co-

operation between the various levels o government.

Transport Strategy Committee on Future Perth (1992)

Transport,

Health

and

PublicPolicy

Sixty years of heavy investment in car-based transport infrastructure have raised our emissions, transport costsand obesity levels

The Queensland transport system, like other Australian states, has developed in a manner heavily

dependent on the private automobile (Queensland Government, 2008). This dependence has

brought a range o unintended consequences in relation to sedentary liestyles, climate change,

congestion and urban liveability.

On average Queenslanders travel more kilometres by passenger vehicle than any other state or

territory14,800 kilometres per vehicle in 2006compared with the national average o 13,900kilometres. (Queensland Government, 2008, p. 23).

Improving our understanding o the ull

benets and costs o dierent modes o

transport can lead to more optimal transport

planning and investment decisions. In

particular, better understanding o the health

benets o active transport and the external

costs1 o motorised transport, can help identiy

the best transport policies and planning

decisions, taking into account all impacts.

2.1 Overlooking the benets o

active transport

Conventional transport economic evaluation

overlooks many active transport benets

(Table 1). For example, by tradition,

transport project evaluation considers

travel time and vehicle operation costs

(and thereore the benets o reduced

congestion), but ignores parking and vehicle

ownership costs. By omitting these latter

considerations, the evaluation ignores thesavings that result rom policies that, by improving travel options, allow households

to own ewer motor vehicles. Similarly, conventional transport economic evaluation

considers the trafc saety benets that result i travellers reduce crash rates per kilometre

o travel, but tends to ignore the saety benets that result i travellers reduce total annual

vehicle-kilometres, or the tness and health benets that result rom increased walking

and cycling.

Against the backdrop oa growing population,

the highest ever obesitylevels and signicant

environmentalchallengescycling

oers a wealth obenets.

National Cycling Strategy, Ausroads, 2010.

1 Externalities are the impacts not covered by the user, e.g. carbon emissions rom transport.

Austroads, 2010.

(Transport Strategy Committee on Future Perth, 1992)

Overlooking the Benets of

Active Transport

2 Transport, Health and Public Policy



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USUALLY CONSIDERED OFTEN OVERLOOKED

Financial costs to governments Downstream congestion impacts

Travel speed (congestion delays) Delay to non-motorised travel (barrier eec t)

Vehic le operating costs (uel, tol ls , tyre wear) Parking costs

Per-kilometre crash rates Vehicle ownership and kilometre-based depreciationcosts.

Per-kilometre emissions Project construction trafc delays

Project construction environmental impacts Generated trafc impacts (additional accidents,energy consumption and pollution emissions rom

induced vehicle travel)

Indirect environmental impacts

Strategic land use impacts (e.g., sprawl)

Transport diversity value

Equity impacts (e.g. mobility or non-drivers)

Impacts on physical activity and public health

Some travellers preerence or alternative modes

IMPROVED ACTIVE

TRANSPORT

CONDITIONS

INCREASED

ACTIVE

TRANSPORT

REDUCED

AUTOMOBILE

TRAVEL

MORE WALKABLE

DEVELOPMENT

Improved userconvenience and comort

Improved population-level physical activity

Reduced trafccongestion

More liveablecommunities

Improved accessibility,

particularly or non-drivers

User enjoyment Road and park ing acil ity

cost savings

Improved accessibility,

reduced transport costs

Option value Increased community

cohesion (positiveinteractions among

neighbours)

Consumer cost savings Reduced vehicle

ownership

Increased propertyvalues

Reduced trafc crashes Reduced sprawl

Energy conservation Habitat preservation

Reduced air and noisepollution

Transport,

Health

and

PublicPolicy

NB: Improving walking and cycling conditions and increased use o these modes can provide many

benets, particularly when they substitute or driving.

Table 2: Walking and Cycling Benefts.

NB: Conventional transport planning tends to ocus on a limited set o impacts. By tradition, many

benets o active transport tend to be overlooked or undervalued.

There are a variety o benets that result rom improved sustainable transport. Some o

these benets result rom improved walking and cycling conditions, others result rom

more active transport activity, and others rom more walkable community development,

and some rom reductions in automobile use, as summarised in Table 2.

This report investigates these benets. It identies various categories o benets, and

methods or quantiying and monetising (measuring in monetary units) these impacts. It

describes a ramework or incorporating these benets into transport policy and planning

analysis.

Table 1: Consideration o Active Transport Benefts.

There are a variety of benets that result from improved sustainable transport. Some of

these benets result from improved walking and cycling conditions, others result from

more active transport activity, and others from more walkable community development,

and some from reductions in automobile use, as summarised in Table 2.

This report investigates these benets. It identies various categories of benets, and

methods for quantifying and monetising (measuring in monetary units) these impacts.

It describes a framework for incorporating these benets into transport policy and

planning analysis.

Table 1: Consideration o active transport benefts

Conventional transport planning tends to focus on a limited set of impacts. By tradition, many

benets of active transport tend to be overlooked or undervalued.

Table 2: Walking and cycling benefts

NB: Improving walking and cycling conditions and increased use of these modes can provide many

benets, particularly when they substitute for driving.



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2.2 Public Policy and Active Transport

Publicpolicyissubjecttoawiderangeofinuencesfrombothwithingovernmentandfrom

the broader community. Concern has been expressed that public sector reorms in many

developed countries over the past couple o decades have had too narrow a ocusand this

is particularly the case with transport policy (Dora & Phillips, 2000). For instance, a road agency

may widen a reeway to relieve congestion without consideration o the negative impact this

may have on amenity and time competitiveness or pedestrians and cyclists

In practice, public policy reorms have oten been ocused on restructuring to achieve internal

eciencies and greater accountability or outcomes, which has meant that other aspects o

public policy have sufered. Curtain (2000, p. 44) concludes:

Australia needs new mechanisms to not only generate new policy ideas that are a departure from

the past. We also need ways to ensure that the new ideas can be fur ther tested and implemented

on a large scale where they are judged to be viable.

This describes the issues that policies relating to active transport and voluntary travel-

behaviour change have been acing or over a decade. The role o evaluation is crucial to

acceptance o these approaches to emerging problems in transport and health and also

to the ability to implement efective programs on a scale large enough to have real and

substantial benets or the community.

Decision-making in government, with regard to unding o programs and initiatives, is both

centralisedanduncoordinated.Thisisnotacontradiction,butareectionofthefactthat

budgeting is primarily concerned with inputs and outputs rather than outcomes. Decisions

on inputs are centralised in Cabinet and Treasury; decisions on outputs are more oten made

at departmental level.

Inputs are the resources (mainly nance to purchase resources such as staf and materials)

required or an agency to create specied outputs. Inputs are typically allocated to an

individual agency, even where these are to be used in joint initiatives with other agencies.

Outputs are the assets or activities that are being unded. Outputs are generally the property

o an individual agency. Even with joint projects, the output is likely to be most clearly

identied with a single agency that takes the lead role in delivery. Output is usually a poor

measure or perormance, as it represents the products or services produced rather than the

value produced or the community.

Outcomes are what the assets or activities deliver to the community. These outcomes may go

well beyond the areas covered by the unded agency or agencies or delivery o outputs. This

is particularly the case with active transport, where the output might be a new shared path

but the outcomes will be spread across transport, environment and health.

Funding is centralised in that the State Budget

is the instrument or determining levels and

allocations o undingin aggregate, or

individual agencies and or specied programs.

Funding is uncoordinated in that the initiative

or seeking unding most oten comes rom anagency that is responsible or the outputs, not

rom those that have a stake in the outcomes.

This is not a new issue (see, or example,

Transport Strategy Committee, 1992) but is one

that is becoming more urgent as governments

and communities become increasingly

concerned with sustainability and, at the

same time, actions in one area o activity have

complex efects on a wide range o sectors.

Where once decision-makers were able to ocus

on the direct impacts o initiatives, they now

have to consider impacts, both positive and

negative, in areas that are the responsibility o others.

The issues o multiplicity o stakeholders and diversity o outcomes are central to

understanding how to approach active transport initiatives in the context o public sector

decision-making. Active transport, partly due to its broad range o impacts, has ailed to

nd a dedicated home within one government sector. It has variously been considered

the responsibility o the transport, environment and health areas o government, but the

outcomes range more broadly into economic and social sustainability, including education

(see Figure 2).

Transport,

Health

and

PublicPolicy

Where once decision-makers were able to

ocus on the directimpacts o initiatives,

they now have toconsider impacts, bothpositive and negative,

in areas that are theresponsibility o others.

.



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Economy

HealthTransport

EnvironmentSociety

Active Transport

Climate Change

Sustainability

Reduced car useMore physical

activity

Less fossil

fuel use

Better accessibility

Less congestion

Lower cost transport

Improved physical

and mental health

Improved

educational

outcomes

Economic

resilience

Local environmental sustainability

Community vitality

Global environmental sustainability

Figure 2: The infuences and outcomes o active transport

The indirect outcomes o active transport do not align with decision-making and

resourcing as simply as do the outputs, suggesting that a whole-o-government

approach to decision-making and resourcing would be desirable. However, as Cavill

(2001) demonstrates, there is not only a synergy o interests between transport and

health proessionals in respect o active transport, there is also a complementarity o

capabilities, skills and experience (Table 3). Similar complementarities are likely to be

ound in respect to other interests and can be built on to improve both the eectiveness

and the efciency o active transport programs.

Globally, cycling is increasingly seen as a smart option for boosting population levels of physical activity

Transport,

Health

and

PublicPolicy



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KEY PRIORITIES AND POTENTIAL CONTRIBUTIONS FOR TRANSPORT AND HEALTH PROFESSIONALS IN PROMOTING

AND INCREASING RATES OF WALKING

Transport Health

Reduce car use Improve health through physical activity

Improve air quality Reduce rates o respiratory diseases/asthma

Reduce trac noise Reduce stress/improve mental health

Reduce congestion Encourage independent mobility and development(especially in children)

Improve road saety Reduce mortality and morbidity rom crashes

Increase liveability o urban areas Improve quality o lie

Increase equity and access to transport modes Reduce inequalities in health

Increase sustainability o the transport system Build social capital and social cohesion

Table 3: Priorities and contributions in transport and health for active transport.Source: Cavill (2001)

2.3 Decision-Making or Active Transport

2.3.1 Evaluation and Complex Systems

Transport strategies have changed direction very substantially since Goodwin et al

(1991) coined the phrase the new realism, but program delivery and the methodology

o evaluation have not kept up. Oten this has been because the linkages between newinitiatives and outcomes are not dened clearly enough or quantied well enough.

In addition, evaluation methodologies oten assume that more is better. Traditional

evaluation methodologies also have diculty coping with changes in what we do

(activity patterns) and changed in how we get there (travel). Consequently, new initiatives

oten have great diculty getting unding (Ker, 2001). Put another way, we commonly set

targets or a reduction in the level o reliance on private car travel in cities, but do little or

nothing to increase the likelihood o those outcomes being achieved.

In addition to State Transport Policies and Metropolitan Transport Strategies, which

embody both the direction and the magnitude o these targets, we have implementation

strategies, that tell usat an almost operational levelwhat needs to be done. Since

many o these initiatives are new, we do not know, a priori, how efective they will be. This

poses problems or both the initial evaluation and or post-implementation monitoring.

Ironically, lack o experience rom which to judge likely efectiveness makes it all the more

important to be able to measure ac tual perormance.

It is increasingly recognised that transport systems and cities are complex adaptive

systems, not mechanisms with uniquely-denable relationships between actions and

outcomes. Complex systems have two key characteristics that make perormance

measurement dicult:

Theycannotbecontrolled,onlyinuencedordisturbed,andthereforethe

precise outcomes cannot be identied a priori.

Theyarepronetoemergenceofnewcharacteristics,denedasoutcomesthat

cannot be predictedlet alone quantiedby our current understanding o

the system (Chambers & Ker, 1997).

Transport,

Health

and

PublicPolicy

The complex, wide-ranging benefts o increased active transport, such improved liveability, warrant urther research

1.

2.

Table 3: Priorities and contributions in transport and health or active transport.Source: Cavill (2001)

KEY PRIORITIES AND POTENTIAL CONTRIBUTIONS FOR TRANSPORT AND HEALTH

PROFESSIONALS IN PROM OTING AND INCREASING RATES OF WALKING

Transport Health

Reduce car use Improve health through physical activity

Improve air quality Reduce rates of respiratory diseases/asthma

Reduce trac noise Reduce stress/improve mental health

Reduce congestion Encourage independent mobility and development

(especially in children)

Improve road safety Reduce mortality and morbidity from crashes

Increase liveability of urban areas Improve quality of life

Increase equity and access to transport modes Reduce inequalities in health

Increase sustainability of the transport system Build social capital and social cohesion



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2.3.2 Complex Outcomes o Active Transport

Active Transport is a classic case o outcomes extending ar beyond the scope o any

single agency responsible or programs and outputs. Most active transport initiatives

have been generated out o transport, environmental and, more recently, health concerns

and the most obvious direct outputs are also in those areas:

reducedcaruse

lessfossil fueluseandassociatedemissions

morephysicalactivity.

The direct outputs are the results that are most commonly measured or estimated

partly because they align so simply with originating agencies and partly because they

can be measured or observed. However, each o these outputs has multiple outcomes:

Reduced car use leads to:

betteraccessibility(socialoutcome)

lesscongestion(economicoutcome)

lower-costtransport(economicandsocialoutcome)

improvedphysicalhealth(economicandsocialoutcome)

improvedmentalhealth(economicandsocialoutcome)

improvededucationaloutcomes(socialandeconomicoutcome)

economicrobustness(economicoutcomewithsocialconsequences)

local environmental(airquality, noise, waterquality) improvements

(environmental, economic and social outcome)

globalenvironmental(climatechange)improvements(environmental,

economic and social outcome).

Less ossil uel use leads to:

economicrobustness

local environmental(airquality, noise, waterquality) improvements


localcommunityvitality(economicandsocialoutcome)

globalenvironmental(climatechange)improvements(environmental, economic and social outcome).

Transport,

Health

and

PublicPolicy

The complex, wide-ranging benefts o increased active transport, such improved liveability, warrant urther research



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More physical activity leads to:

improvedphysicalhealth(economicandsocialoutcome)

improvedmentalhealth(economicandsocialoutcome)

improvededucationaloutcomes(socialandeconomicoutcome)

local environmental (air quali ty, noise, water quali ty) improvements


globalenvironmental(climatechange)improvements(environmental,

economic and social outcome).

Even those outcomes that can be measured or observed are usually dicult to interpret

because o the large number o other actors, beyond the active transport initiative, that

can afect them.

Shiel, in a brie commentary on the walking school bus, demonstrates the need to take

into account the ull range o outcomes (not s imply health) or an efective evaluation o

program value. He concludes:

The ethical imperative o opportunity cost demands we evaluate the costs and benets o healthpromoting interventions. The WSB [walking school bus] example suggests that methodologically

health economics has some way to go beore it can stand up to the challenge o social

interventions. The alternative is we value only that which has been measured, and this may mean

the end o the line or social interventions such as the walking school bus. (Shiel, 2007, p. 334)

It is essential that economic evaluation ensures that all signicant costs and benets

are identiedeven i they cannot all be measured and valuedlest they be otherwise

overlooked. The evaluation ramework or active travel in Queensland will be broad-

based and inclusive to provide a comprehensive evaluation to support public policy

decisions across government.

Giles-Corti et al (2010, p. 125) concluded that:

As societies conront the economic, social and environmental eects o climate change, populationgrowth, trafc congestion and the burden o chronic disease, there is a unique opportunity to

view the benets o active transportation through a multi-sector lens. Studying the co-benets

o policy options how

Qld Health_june 1

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