Is cycle network expansion cost-effective? A health economic evaluation of cycling in Oslo

Exploring the Multiscale Relationship between the Built Environment and the Metro-Oriented Dockless Bike-Sharing Usage

Dockless bike-sharing systems have become one of the important transport methods for urban residents as they can effectively expand the metro’s service area. We applied the ordinary least square (OLS) model, the geographically weighted regression (GWR) model and the multiscale geographically weighted regression (MGWR) model to capture the spatial relationship between the urban built environment and the usage of bike-sharing connected to the metro. A case study in Beijing, China, was conducted. The empirical result demonstrates that the MGWR model can explain the varieties of spatial relationship more precisely than the OLS model and the GWR model. The result also shows that, among the proposed built environment factors, the integrated usage of bike-sharing and metro is mainly affected by the distance to central business district (CBD), the Hotels-Residences points of interest (POI) density, and the road density. It is noteworthy that the effect of population density on dockless bike-sharing usage is only significant at weekends. In addition, the effects of the built environment variables on dockless bike-sharing usage also vary across space. A common feature is that most of the built environment factors have a more obvious impact on the metro-oriented dockless bike-sharing usage in the eastern part of the study area. This finding can provide support for governments and urban planners to efficiently develop a bike-sharing-friendly built environment that promotes the integration of bike-sharing and metro.

Cycle-network expansion plan in Oslo: Modeling cost-effectiveness analysis and health equity impact

Physical inactivity is the leading cause of non-communicable diseases, and further research on the cost-effectiveness of interventions that target inactivity is warranted. Socioeconomic status is vital in this process. We aim to evaluate the cost-effectiveness of a cycle-network expansion plan in Oslo compared to the status quo by income quintiles. We applied a Markov model using a public payer perspective. Health outcomes were measured by quality-adjusted life years (QALYs) gained from the prevention of coronary heart disease, stroke, type 2 diabetes, and cancer. We measured equity impact by the concentration index and social welfare using the achievement index. We conducted sensitivity analyses. The intervention was generally more costly and more effective than the status quo. Incremental cost per QALY falls with income quintile, ranging from $10,098 in the richest quintile to $23,053 per QALY gained in the poorest quintile. The base-case intervention increased health inequality. However, a scenario targeting low-income quintiles reduced inequality and increased social welfare. In conclusion, the cycle-network expansion is likely to be cost-effective, but with equity concerns. If decision makers care about health inequalities, the disadvantaged groups could be targeted to produce more equitable and socially desirable outcomes instead of a uniform intervention across income quintiles.

Prevalence and patterns of physical activity, sedentary behaviour, and their association with health-related quality of life within a multi-ethnic Asian population

OBJECTIVE

The study aimed to examine the prevalence and sociodemographic correlates of physical activity and sedentary behaviour in the general population of the multi-ethnic nation of Singapore as part of the Knowledge, Practice and Attitudes towards Diabetes study, a cross-sectional and population-based survey. It also examined the relationship between physical activity, sedentary behaviour, and health-related quality of life (HRQoL).

METHODS

Physical activity and sedentary behaviour were assessed via the Global Physical Activity Questionnaire (GPAQ), while physical and mental HRQoL was assessed via the Short Form Health Survey (SF-12v2). Survey weights were employed to account for complex survey design. Multivariable logistic regression models were utilized to examine sociodemographic correlates of physical activity (insufficient vs. sufficient physical activity) and sedentary behaviour (< 7 h/day vs ≥7 h/day). Descriptive statistics were calculated to examine the percentage of time spent in different domains of physical activity. Multivariable linear regressions were conducted to examine the association between physical activity and sedentary behaviour with physical and mental HRQoL.

RESULTS

Two thousand eight hundred sixty seven participants recruited from February 2019 to March 2020 (prior to COVID-19 lockdown and related restrictions in Singapore) were included in the analyses. 83.3% of respondents had sufficient physical activity. Age (65 years and above) and income (SGD 2000 to 3999) were associated with a higher likelihood of insufficient physical activity. In contrast, those of Malay ethnicity and having one chronic physical condition were associated with a lower likelihood of insufficient physical activity. 47.7% reported that they had sedentary behaviour of ≥7 h/day. Older age and a primary school education were related to a lower likelihood of sedentary behaviour, while being single, having higher income, obesity, and multimorbidity were associated with higher sedentary behaviour. Insufficient physical activity was significantly associated with lower physical HRQoL but was not significantly associated with mental HRQoL. Sedentary behaviour was not significantly associated with mental or physical HRQoL.

CONCLUSION

About 17% of the population did not meet the minimum requirements for physical activity, while around half of the population spent a considerable time being sedentary. As insufficient physical activity was associated with poorer physical HRQoL, policymakers should promote moderate physical activity and encouraging the breaking up of prolonged sedentary periods within the middle- and high-income groups, especially at the workplace. Increased leisure-time exercise should be encouraged for those in the lower- income group.

Determinants of bicycle commuting and the effect of bicycle infrastructure investment in London: Evidence from UK census microdata

Worldwide, concern about physical inactivity and excessive car dependence has encouraged ambitious targets and policies to promote cycling. But policy making is hindered by limited knowledge about why cycling prevalence and trends vary greatly between different geographic areas (e.g. in London (UK) <1% cycle to work in Harrow compared to>15 % in Hackney) and individuals (e.g. by age or gender). The role of cycle infrastructure investment in explaining part of these patterns and trends is also unknown. We linked individual-level data on 317,117 London commuters (including 11,199 cyclists) in the 2001 and 2011 UK census to relevant geographic data, including on area-level cycling infrastructure investment during the period. Whilst cycle commuting increased over time on average, concentration curves and indices demonstrated that in contrast with England as a whole, cycling in London shifted from being dominated by commuters with lower socioeconomic status to commuters with higher socioeconomic status. In our first set of regression analyses, we showed that observed differences and time trends in cycling prevalence were partially explained by area-level differences in topography, greenspace, footpaths and crime levels and by differences and changes in population structures. In the second, we conducted a cost-effectiveness analysis which showed that expenditure on cycling infrastructure was associated with increased cycling at a marginal rate of £4915 per additional commuter cyclist, with some variation between groups: ethnic minorities were more responsive, and females, older people and those with lower socioeconomic status appeared less responsive. If planned increases in expenditure in England for the period 2020-25 were as cost-effective, and were sustained for the whole decade, our study suggests that commuter cycling prevalence could increase in England by 0.5 to 1.1 percentage points (this equates to a 16% to 34% increase in commuter cycling prevalence if compared to 2011 levels). More research is necessary to assess the impact on broader measures of cycling, active travel and overall physical activity, and to determine whether such expenditure constitutes good or equitable value for money.

The Health Cost of Transport in Cities

Purpose of Review

The study aims to provide an understanding of health cost assessments of different transport modes in urban contexts, and their relevance for transport planning and political decision-making.

Recent Findings

There is strong evidence that motorized transportation imposes a high health cost on society, and specifically children. In contrast, active transport is a very significant health benefit.

Summary

Economic analyses support urban change in favor of compact neighborhoods and public transit, as well as infrastructure exclusively devoted to active transport. Private cars need to be restricted because of the high cost they impose on society.