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The environmental, health, social, and equity benefits of shifting to active transport modes, specifically human-powered transport like bicycling and walking, for short commute trips. It also explores the safety implications of such a shift, including the safety in numbers effect and the impact of infrastructure on cycling numbers and crash rates. The document uses data from auckland, new zealand, to develop relationships between changes in population perception and changes in transport mode share.
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Environmental Health Perspectives • volume 122 |^ number 4 |^ April 2014 335
All EHP content is accessible to individuals with disabilities. A fully accessible (Section 508–compliant) HTML version of this article is available at http://dx.doi.org/10.1289/ehp..
Alexandra Macmillan,^1 Jennie Connor,^2 Karen Witten,^3 Robin Kearns,^4 David Rees,^5 and Alistair Woodward^1 (^1) School of Population Health, University of Auckland, Auckland, New Zealand, 2 Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand; 3 Social and Health Outcomes Research and Evaluation (SHORE), Massey University, Auckland, New Zealand; 4 School of Environment, University of Auckland, Auckland, New Zealand; 5 Synergia Ltd, Auckland, New Zealand B ackground : Shifting to active modes of transport in the trip to work can achieve substantial co-benefits for health, social equity, and climate change mitigation. Previous integrated modeling of transport scenarios has assumed active transport mode share and has been unable to incorporate acknowledged system feedbacks. oBjectives: We compared the effects of policies to increase bicycle commuting in a car-dominated city and explored the role of participatory modeling to support transport planning in the face of complexity. Methods: We used system dynamics modeling (SDM) to compare realistic policies, incorporating feedback effects, nonlinear relationships, and time delays between variables. We developed a system dynamics model of commuter bicycling through interviews and workshops with policy, community, and academic stakeholders. We incorporated best available evidence to simulate five policy scenarios over the next 40 years in Auckland, New Zealand. Injury, physical activity, fuel costs, air pollution, and carbon emissions outcomes were simulated. results : Using the simulation model, we demonstrated the kinds of policies that would likely be needed to change a historical pattern of decline in cycling into a pattern of growth that would meet policy goals. Our model projections suggest that transforming urban roads over the next 40 years, using best practice physical separation on main roads and bicycle-friendly speed reduction on local streets, would yield benefits 10–25 times greater than costs. conclusions : To our knowledge, this is the first integrated simulation model of future specific bicycling policies. Our projections provide practical evidence that may be used by health and transport policy makers to optimize the benefits of transport bicycling while minimizing negative consequences in a cost-effective manner. The modeling process enhanced understanding by a range of stakeholders of cycling as a complex system. Participatory SDM can be a helpful method for integrating health and environmental outcomes in transport and urban planning. citation : Macmillan A, Connor J, Witten K, Kearns R, Rees D, Woodward A. 2014. The societal costs and benefits of commuter bicycling: simulating the effects of specific poli- cies using system dynamics modeling. Environ Health Perspect 122:335–344; http://dx.doi. org/10.1289/ehp.
Car use is the dominant mode of transport to work in many high-income cities. In car-oriented cities, commuting by private motor vehicle allows access to employment and training (crucial social determinants of health) while enabling households to man- age competing responsibilities. However, car-dependent commuting has significant negative public health effects for commuters, the wider community, and local and global ecosystems. A mode shift to greater use of active transport would bring environmental, health, social, and equity benefits (de Nazelle et al. 2011; Hosking et al. 2011). In high- income cities, car commutes tend to be short, habitual, solitary trips in congested traffic. Consequently, they make a greater contribu- tion to road traffic injury (Bhalla et al. 2007), air pollution and transport greenhouse gas emissions (André and Rapone 2009), noise (Hänninen and Knol 2011), and stress (Jansen et al. 2003) than other kinds of light vehicle trips. Traffic congestion at peak com- mute times is also a significant influence on constructing new road capacity with land use, environmental, and social costs (Coffin 2007; Fahrig 2003). In addition, the predict- ability of car commuting routes may make these trips amenable to a wider range of policy alternatives. Previous integrated health impact assess- ments, based on existing evidence, suggest that a shift to human-powered transport modes (bicycling, walking, running, wheel- chair, skating) for short commute trips would be good for health, aside from the risk of road traffic injury (Hosking et al. 2011; Woodcock et al. 2009). These trips incur negligible greenhouse gas and air pollution costs, incorporate physical activ- ity into people’s daily lives, and cost little (potentially increasing equitable access to jobs) (Hosking et al. 2011). Although trans- port policy is identified as a determinant of the global noncommunicable disease (NCD) crisis, transport interventions have not been included in the United Nations’ priority actions for NCDs because of poor evidence of cost-effectiveness (Beaglehole et al. 2011). Previous comparative risk assessments have been undertaken for transport policy, climate change, and health (e.g., Lindsay et al. 2011; Rojas-Rueda et al. 2011; Woodcock et al. 2009). However, these assessments have been unable to directly compare specific policies seeking to increase active transport, and have not incorporated recognized system feedbacks (Woodcock et al. 2009). The relationships between urban planning and health are complex, and evi- dence for them varies widely in source and quality. Furthermore, policies may trade gains made against some objectives at the expense of others. However, a set of methodological recommendations is emerging in the literature that might promote effective policy decisions in such complex systems. They include a sys- tems approach; transdisciplinarity (integrating knowledge across policy, community, and the academy); community participation in deci- sion making; and a focus on social justice and environmental sustainability (Charron 2012). There have been recent calls for complex sys- tems research to tackle deep-seated problems such as physical inactivity (Kohl et al. 2012), obesity (Swinburn et al. 2011), and improving the contribution of urban planning to health (Rydin et al. 2012). We used the principles above to develop a commuter cycling and public health model integrating physical, social, and environmental well-being. We used this model to identify Address correspondence to A. Macmillan, Department of Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin 9056, New Zealand. Telephone: 64 3 479 7196. E-mail: alex.macmillan@otago.ac.nz Supplemental Material is available online (http:// dx.doi.org/10.1289/ehp.1307250). We thank the organizations and individuals who participated in the interviews and workshops; S. Turner (Beca Infrastructure Ltd) and G. Koorey (University of Canterbury) for peer reviewing aspects of the simulation model; and J. Woodcock (Centre for Diet and Activity Research, Cambridge University) for his helpful comments on an earlier draft of the manuscript. This research was funded by the Health Research Council of New Zealand. A.M. also received sup- port from the NZ Transport Agency and the NZ Ministry of Health. D.R. is employed by Synergia Ltd, Auckland, New Zealand. The authors declare they have no actual or potential competing financial interests. Received: 19 June 2013; Accepted: 3 February 2014; Advance Publication: 4 February 2014; Final Publication: 1 April 2014.
Macmillan et al. 336 volume 122 |^ number 4 |^ April 2014 • Environmental Health Perspectives cost-effective transport policies for improving public health. Auckland, New Zealand’s largest and fastest growing city (population ~ 1.5 million), was the case study. A program of motorway development and low-density urban growth in Auckland has led to exponential growth in car owner- ship and use, with a collapse in use of public transport and bicycling as modes of transport (Mees 2010). Private motor vehicles are used for > 75% of commutes, and bicycles 1%. Recently, Auckland’s regional government has been promoting bicycling for transport to reduce motor vehicle use.
We used participatory system dynamics modeling (SDM) to involve community, academic, and policy stakeholders in a process that explored the dynamic effects of realistic policies. SDM is based on the following principles (Richardson 2011):
Macmillan et al. 338 volume 122 |^ number 4 |^ April 2014 • Environmental Health Perspectives during the incorporation of local data and validity testing. These are shown in dotted lines in Figure 1. In an alternative theory to B1, a “safety in numbers” loop is described in R3 (more people bicycling leads to a reduc- tion in the rate of cyclist injuries). There is ecological evidence for a safety in numbers effect for bicycling (Jacobsen 2003; Tin Tin et al. 2011; Vandenbulcke et al. 2009), but this very likely combines the impact of safer infrastructure on cycling numbers and a direct effect of cyclist numbers on crash rates (Bhatia and Wier 2011; Wegman et al. 2010). We tested this theory using longi- tudinal bicycling mode share (census) and bicycling injury data (NZ Transport Agency
Integrated assessment of cycling policies using SDM Environmental Health Perspectives • volume 122 |^ number 4 |^ April 2014 339 on local and arterial road collisions (Turner et al. 2009) and our modified safety-in- numbers effect;
Integrated assessment of cycling policies using SDM Environmental Health Perspectives • volume 122 |^ number 4 |^ April 2014 341 All the intervention scenarios achieve sav- ings in all-cause mortality through an increase in population levels of physical activity. The savings range from tens of lives per year (RCN and SER) to hundreds of lives per year (ASBL and combined best practice). There are projected fuel cost savings under all scenarios (including slight savings even with no intervention), which will increase over time if rising fuel prices outstrip improvements in light vehicle fuel efficiency. According to our simulations, the RCN and SER scenar- ios would achieve annual fuel cost savings in hundreds of millions of $NZ due to increased commuter bicycling, while the ASBL and com- bined best practice scenarios would achieve annual savings in billions of dollars (Table 3). Table 3 illustrates the estimated cumu- lative costs and benefits to 2051 of the four policy interventions compared with the business-as-usual simulation. All interven- tions exhibit positive benefit–cost ratios, ranging from $NZ6 to > $NZ20 saved for every dollar spent on bicycling infrastruc- ture. The largest savings come from reduc- tions in all-cause mortality due to physical inactivity. However, the distribution and magnitude of costs and savings vary widely between scenarios. Although the RCN is cheap to build (~ $NZ45 million), it achieves only a small shift in mode share accompa- nied by a large injury burden, resulting in net benefits in the hundreds of millions of dol- lars. Yet the combined best practice scenario, although considerably more expensive to build (approximately $NZ630 million), achieves a much larger mode shift with a similar num- ber of bicycling injuries and a cumulative net benefit in tens of billions of dollars, as shown in Table 3. In this scenario, bicycling fatalities are offset by the reduction in other motor vehicle injuries. Because a major effect of the SER intervention is to reduce vehicle use by making it less convenient (Charlton et al. 2010), rather than to directly increase bicycling, further effects of the SER scenario will accrue through increases in all non- car transport modes (including walking and Figure 2. Dynamic model outputs 1991–2051. (A) Commuter bicycling mode share. (B) Annual serious and fatal injuries to commuter cyclists due to collisions with light vehicles. (C) Commuter cyclist injury rate per 1,000 cyclists. (D) Mortality due to air pollution from the commuting light vehicle fleet. 1991 2006 2021 2036 2051 0
1 2 3 1 2 3 1 2 1 2 3 3 4 4 4 4 5 5 5 5 1991 2006 2021 2036 2051 0 500 1000 1 2 1 2 1 1 2 2 3 3 3 3 4 4 4 4 5 5 5 5 1991 2006 2021 2036 2051 0 5 10 1 1 1 1 2 3 2 3 2 2 (^33) 4 4 (^4 ) 5 5 (^5 ) 2021 Year Year 1991 2006 2036 2051 0 10 20 1 1 (^1 ) 2 2 2 2 3 3 3 3 4 4 4 4 5 5 5 5 Bicycle mode share Cyclist serious injuries and deaths Cyclist serious injury and death rate (per 1,000 cyclists) Annual air pollution mortality 1, Baseline 2, RCN 3, ASBL 4, SER 5, ASBL + SER Table 3. Cumulative outcomes projected from the simulation of active policy scenarios compared with the business-as-usual scenario. Outcome RCN (monetized) ASBL (monetized) SER (monetized) ASBL + SER (monetized) Cycling mode share by 2051 (%) 5 20 5 40 LV mode share by 2051 (%) 75 65 55 40 Proportion of people considering cycling always/mostly safe by 2040 0.4 0.7 0.3 0. LVKT (billion km) –3.5 –7 –10 –18. Cyclist injuries Fatalities 200 (620) 360 (1,100) 85 (250) 250 (850) Serious injuries 4,000 (1,300) 7,000 (2,300) 1,600 (500) 5,000 (1,600) Car crashes Car occupant fatalities –70 (–220) –120 (–370) –170 (–527) –340 (–1,000) Air pollution Mortality –10 (–7.5) –20 (–15) –40 (–30) –80 (–60) Hospitalizations –5 (–0.02) –15 (–0.04) –20 (–0.06) –40 (–0.12) COPD incidence –10 (–0.75) –30 (–2.25) –55 (–4) –90 (–6.75) Restricted activity days –12,500 (–1) –37,200 (–4) –57,700 (–6) –112,200 (–11) Air pollution total (–9) (–21) (–40) (–78) All-cause mortality –650 (–2,000) –1,850 (–5,700) –650 (–2,000) –4,000 (–12,400) Greenhouse gas emissions (megatons) –3 (–120) –8 (–360) –13 (–520) –26 (–1040) Fuel cost ($NZ million) (–600) (–1,800) (–600) (–3,900) Infrastructure cost ($NZ million) (45) (250) (380) (630) Net benefit ($NZ million) –770 –2,550 –1,780 –13, Benefit–cost ratio 18 18 6 24 Abbreviations: LV, light vehicle; LVKT, light vehicle kilometers travelled. Numbers with a negative sign represent savings. Monetized figures are given in parentheses and are in millions of New Zealand dollars. Benefit–cost ratios are calculated from the net public health benefits and infrastructure costs shown.
Macmillan et al. 342 volume 122 |^ number 4 |^ April 2014 • Environmental Health Perspectives public transport). Therefore, counting only the benefits and costs due to an increase in commuter bicycling reflects only part of the benefits and costs of this intervention. Policy sensitivity analysis. The results of the policy parameter testing are summarized in the Supplemental Material, Tables S4–S and Figures S1–S6. Realistic changes to pol- icy assumptions did not change the shape of outcome behaviors over time. However, injury outcomes were sensitive to safety-in- numbers assumptions. In particular, simulat- ing the no-threshold power function proposed by Jacobsen (2003) altered the shape of change over time of injury outcomes for all scenarios, but worsened the validity against historical data. The Monte Carlo analysis demonstrated order-of-magnitude variability in mode share outcomes only for the SER policy. Overlap in the mode share effects of some policies was evi- dent, but the model continued to distinguish among the RCN, ASBL, and combined best practice policies (see Supplemental Material, Table S7 and Figure S6). Simulating the reported range of effects of commuter cycling on all-cause mortality altered the order of mag- nitude of savings, and the model was not able to distinguish between scenarios because of overlapping effects. Plausible variation in lead times for physical activity benefits led to order- of-magnitude differences in outcomes, while retaining the ability to distinguish between the RCN and combined best practice scenarios. Even under a best-case scenario, the RCN would result in an increase in the cyclist injury rate (Figure 2C; see also Supplemental Material, Figure S1) because the infrastructure components have the potential to make cycling more dangerous, while failing to achieve the mode shift necessary to reduce vehicle growth or reach the safety in numbers threshold. On the other hand, policies 4 (SER) and 5 (ASBL
Principal findings. Under our primary model assumptions, the benefits of all the interven- tion policies outweighed the harms, between 6 and 24 times. However, there were order- of-magnitude differences in estimated net benefits among policies. A universal approach to bicycle-friendly infrastructure will likely be required to achieve sufficient growth in bicycle commuting to meet strategic goals. Our findings suggest that the most effective approach would involve physical segregation on arterial roads (with intersection treatments) and low speed, bicycle-friendly local streets. We estimate that these changes would bring large benefits to public health over the coming decades, in the tens of dollars for every dollar spent on infrastructure. The greatest benefits accrue from reduced all-cause mortality due to population-level physical inactivity. The modeling enabled discussions about the forces behind bicycling trends between policy and nongovernment actors, based on a shared structural understanding. By develop- ing a more consistent, shared, structure-based understanding, we expect this participatory modeling process to reduce conflict among policy stakeholders and successfully support policy change. Simulating the model delivered further insights, identifying feedback loops that were inactive and enabling comparison between plausible policies to demonstrate how strategic targets could be met. Conflicting, mismatched, and unrealistic targets were also identified. For example, meeting the postulated bicycling mode share target was possible through sev- eral of the policies simulated. However, none met the perception of safety target. Except for the combined best practice policy, increases in cycling mode share conflicted with targets to reduce road traffic deaths and injuries. The dynamic output graphs suggest that the planned RCN is unlikely to meet regional tar- gets and fails to address the projected business- as-usual increase in the bicycling injury rate. Through the integrated modeling of benefits we were able to show that a more ambitious approach would be cost-effective. Strengths and weaknesses. To our knowl- edge, this is the first integrated assessment of specific alternative active transport policies, and one of the first uses of SDM to integrate health, social, and environmental outcomes of urban policies. The study builds on previous inte- grated assessments of transport policies (e.g., Lindsay et al. 2011; Rojas-Rueda et al. 2011; Woodcock et al. 2009). The model improves our understanding of active transport policy impacts by circumventing the limitations of both small-scale, rigorous interventions (Ogilvie et al. 2004) and larger ecological com- parisons (Buehler and Pucher 2011). By com- bining local stakeholder knowledge, regional data, and epidemiological evidence using SDM, we were able to combine the structural and the social influences on cycling uptake with evidence-based and context-specific emphasis given to each. The method allowed us to model bicycling collisions and injuries with greater sophistica- tion, including a more nuanced approach to safety in numbers and a more sophisticated model of the effects of traffic speed than previ- ous studies. It also enabled us to account for expected dynamic changes in all-cause mortal- ity and the light vehicle fleet, and to undertake a deeper analysis of structural and parametric uncertainty. However, we were able to include only bicycling injuries occurring as a result of a collision with a light vehicle. Collisions with heavy vehicles, other cyclists, and pedestrians and cyclist-only injuries were not included. Although collisions with motor vehicles account for > 90% of the serious injuries and fatalities reported in New Zealand’s crash analysis, other kinds of cyclist injuries are also likely to increase with increasing bicycle mode share. The relative risks from bicycling cohort studies used in our model may overestimate the mortality benefit of commuter bicycling. These relative risks are larger than expected from meta-analyses of physical activity (Löllgen et al. 2009; Woodcock et al. 2011). Conversely, there are likely benefits not yet able to be counted because of a lack of quan- tified evidence. These include reductions in inactivity-related morbidity, increased social connection, and local economic benefits. The development of a useful SDM requires a balance between parsimony and accuracy. Consistent with most SDM endeavors, our goal was to develop a reflective model for enhancing communication and understanding of system structure and behavior. Although the assumptions meant it was not possible to make point predictions of policy effects, robust policy insights can to be drawn despite mixed quality data. Implications for policy and practice. In high-income, car-dependent cities such as Auckland, particular bicycle-friendly interven- tions will be crucial to turn patterns of declin- ing commuter cycling into sustained growth that would meet climate and health goals. Although our findings suggest that Auckland’s existing plan to develop a regional cycle net- work would likely have benefits, the simulation modeling suggests that it would not reverse the predicted business-as-usual increased rate of cycling injury. In contrast, a gradual trans- formation of all roads using best practice arte- rial and local street interventions could make a major contribution to regional transport targets. Our projections suggest that, assuming our assumptions are valid, this transition would be cost-effective, returning tens of dollars in benefits for every dollar spent. Participatory SDM represents a methodo- logical step forward for health impact assess- ment. As well as being applicable to other transport and land use policies, it could assist with intervening in the wider interdependent systems driving obesity, physical inactivity, and climate change. Implications for future research. The sen- sitivity analysis identified important assump- tions, and therefore future research directions. The model was most sensitive to assumptions about safety in numbers, highlighting the need for longitudinal studies of cycling inju- ries accounting for both infrastructure and cyclist numbers. Although the causal loop diagram is context specific, we find it a useful basis for
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