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Prev Med. 2014 Oct;67:322-9. doi: 10.1016/j.ypmed.2014.07.041. Epub 2014 Aug 11.

The cost-effectiveness of installing sidewalks to increase levels of transport-walking and health.

Author information

1
McCaughey Centre, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia. Electronic address: lgunn@unimelb.edu.au.
2
Queensland Centre for Mental Health Research, The University of Queensland, QLD, Australia.
3
School of Population Health, The University of Western Australia, WA, Australia.
4
Centre for Excellence in Intervention Prevention Science, Melbourne, VIC, Australia.
5
McCaughey Centre, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.

Abstract

OBJECTIVE:

This study investigated the cost-effectiveness of installing sidewalks to increase levels of transport-walking.

METHODS:

Secondary analysis using logistic regression established the association of sidewalks with transport-walking using two transport-walking thresholds of 150 and 60 min/week using Western Australian data (n=1394) from 1995 to 2000. Minimum, moderate and maximum interventions were defined, associated respectively with one sidewalk, at least one sidewalk and sidewalks on both sides of the street. Costs, average and incremental cost-effectiveness ratios were calculated for each intervention and expressed as 'the cost per person who walks for transport for more than 150 min/week (60 min/week) after the installation of new sidewalks'. A sensitivity analysis examined the robustness of the incremental cost-effectiveness ratios to varying model inputs. Costs are in 2012 Australian dollars.

RESULTS:

A positive relationship was found between the presence of sidewalks and transport-walking for both transport-walking thresholds of 150 and 60 min/week. The minimum intervention was found to be the most cost-effective at $2330/person and $674/person for the 150 and 60 min/week transport-walking thresholds respectively. Increasing the proportion of people transport-walking and increasing population density by 50% improved the cost-effectiveness of installing side-walks to $346/person.

CONCLUSIONS:

To increase levels of transport-walking, retrofitting streets with one sidewalk is most cost-effective.

KEYWORDS:

Active transportation; Built environment; Economic analysis; Physical activity; Public health

PMID:
25124280
DOI:
10.1016/j.ypmed.2014.07.041
[Indexed for MEDLINE]

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