Health impact assessment of increasing public transport and cycling use in Barcelona: A morbidity and burden of disease approach

- We assess the health impacts of replacing car trips by bicycle or public transport.
- We estimate the impacts of physical activity, air-pollution and traffic incidents.
- Replace car trips can reduce disease cases and injuries in travelers.
- Replace car trips can reduce disease cases related to PM2.5 in general population.
- All-cause mortality can be an indicator for the disease impacts in transport models.

ObjectiveQuantify the health impacts on morbidity of reduced car trips and increased public transport and cycling trips.MethodsA health impact assessment study of morbidity outcomes related to replacing car trips in Barcelona metropolitan (3,231,458 inhabitants). Through 8 different transport scenarios, the number of cases of disease or injuries related to physical activity, particulate matter air pollution < 2.5 μm (PM2.5) and traffic incidents in travelers was estimated. We also estimate PM2.5 exposure and cases of disease in the general population.ResultsA 40% reduction in long-duration car trips substituted by public transport and cycling trips resulted in annual reductions of 127 cases of diabetes, 44 of cardiovascular diseases, 30 of dementia, 16 minor injuries, 0.14 major injuries, 11 of breast cancer and 3 of colon-cancer, amounting to a total reduction of 302 Disability Adjusted Life Years per year in travelers. The reduction in PM2.5 exposure in the general population resulted in annual reductions of 7 cases of low birth weight, 6 of preterm birth, 1 of cardiovascular disease and 1 of lower respiratory tract infection.ConclusionsTransport policies to reduce car trips could produce important health benefits in terms of reduced morbidity, particularly for those who take up active transportation.