Advancing project-scale health impact modeling for active transportation: A user survey and health impact calculation of 14 US trails

Abstract

Abstract Only 21% of American adults achieve recommended levels of physical activity. Urban trails are popular venues both to engage in recreational physical activities and for active commuting. The Rails-to-Trails Conservancy's Trail Modeling and Assessment Platform (T-MAP) is a multi-year research project to develop data-driven trail planning and management tools. We surveyed over 3000 trail users on 14 US urban trails. The survey was developed specifically to inform health impact calculation, including items on trail use and other physical activity. We calculate health impacts in terms of six chronic diseases and mortality, and use treatment costs and Value of Statistical Life (VSL) for monetization, respectively. Regular trail use prevents 36 hospitalizations due to chronic diseases and 182 premature deaths per 100,000 trail users and year, worth $2,1 million in avoided treatment costs and $1,7 billion based on VSL, respectively. Compared to VSL, avoided treatment costs provide more tangible estimates of health impacts, but challenges with data availability and comparability call for cautious interpretations. Our estimates for chronic disease cases are limited to hospitalization discharges and treatment costs, resulting in considerably lower figures than those for reduction in mortality risk. Trail users are a highly active population. 40% achieve physical activity recommendations even without trail use, and with trail use, 87% do. Health benefits would be more than double if inactive subjects would take up the same amount of trail use as observed in our sample.