Health impact assessment of cycling networks of seven, diverse European cities: Application of the PASTA model

Abstract

Introduction: In times of contemporary sedentarism and the convenience of motor transport, active mobility (AM; walking and cycling for transport) can provide substantial health benefits by increasing levels of physical activity (PA) and help reduce transport-associated emissions. Our aim was to conduct a health impact assessment (HIA) of cycling networks of seven diverse European cities (Antwerp, Barcelona, London, Orebro, Rome, Vienna, Zurich) that form part of the Physical Activity through Sustainable Transport Approaches (PASTA) project. We were interested in assessing whether the length of the cycling network (km) predicts the cycling mode share (%) and what the associated health impacts and co-benefits might be. Methods: We developed and applied the PASTA HIA model to a comparable AM measure (i.e. km of cycling network) across the seven PASTA cities. City characteristics of demographics, cycling network, mode share, PA levels, air quality, traffic safety and health status were collected from city, transport and health statistics. Across different scenarios, we estimated how increases in km of cycling network would lead to increases in cycling mode share. We quantified health impacts of increases in cycling mode share in terms of changes to PA levels, exposure to air pollution and traffic hazards. Exposure response functions were obtained from the literature based on best available evidence. Results: Our results show that the extension of cycling networks can explain up to 80% of variability in cycling mode share in the seven PASTA cities. Health benefits resulting from increases in cycling mode share are predominantly due to increases in PA levels that outweigh associated detriments of air pollution exposure and traffic incidents. Environmental co-benefits were estimated. Conclusions: Expansion of cycling networks in European cities can promote increases in cycling mode share. Increases in cycling mode share provide considerable health and other co-benefits.