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. 2012 Jul 24;2(4):e001135.
doi: 10.1136/bmjopen-2012-001135. Print 2012.

Health Impact Assessment of increased cycling to place of work or education in Copenhagen

Astrid Ledgaard Holm  1 , Charlotte Glümer, Finn Diderichsen
Affiliations

Health Impact Assessment of increased cycling to place of work or education in Copenhagen

Astrid Ledgaard Holm et al. BMJ Open. .

Abstract

Objective: To quantify the effects of increased cycling on both mortality and morbidity.

Design: Health Impact Assessment.

Setting: Cycling to place of work or education in Copenhagen, Denmark.

Population: Effects were calculated based on the working-age population of Copenhagen.

Main outcome measures: The primary outcome measure was change in burden of disease (measured as disability-adjusted life years (DALY)) due to changed exposure to the health determinants physical inactivity, air pollution (particulate matter <2.5 μm) and traffic accidents.

Results: Obtainment of the proposed increase in cycling could reduce the burden of disease in the study population by 19.5 DALY annually. This overall effect comprised a reduction in the burden of disease from health outcomes associated with physical inactivity (76.0 DALY) and an increase in the burden of disease from outcomes associated with air pollution and traffic accidents (5.4 and 51.2 DALY, respectively).

Conclusion: This study illustrates how quantitative Health Impact Assessment can help clarify potential effects of policies: increased cycling involves opposing effects from different outcomes but with the overall health effect being positive. This result illustrates the importance of designing policies that promote the health benefits and minimise the health risks related to cycling.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
Overview of the process of health impact assessment with specific focus on quantitative effect analysis. The left side of the figure shows a generalised Health Impact Assessment process, while the right side focuses on the effect analysis stage, involving two subanalyses: (1) the potential effects of the policy on population (or subpopulation) exposure to selected determinants of health (changed exposure) were estimated based on an analysis of the policy, study population characteristic and information on baseline level of exposure to determinants of health. (2) Next, the potential effect of changed population exposure to determinants of health on burden of disease was estimated based on the results of the first subanalysis (change in exposure to health determinants), information on baseline level of burden of disease from the included health outcomes and causal effect estimates of the associations between included determinants of health and health outcomes. The change in burden of disease was estimated for both each determinant of health and each health outcome and aggregated for all included health outcomes (model was developed based on7).
Figure 2
Figure 2
Analytical model of the health impact assessment of increased cycling to place of work or education. The figure illustrates the relationship between policy proposal, relevant health determinants, health outcomes and aggregated effect.
See this image and copyright information in PMC

References

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