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Department of Public Health

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Health Impact Assessment of CommutingA quantitative analysis of changes in burden of disease due to increased commuting by bicycle in and out of Copenhagen

Astrid Ledgaard Holm

HIA International Conference Granada14th of April 2011

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Department of Public Health

Context of the study

- 37% of everyone working or studying in Copenhagen choose to go by bike

- By 2015 Copenhagen aims to: Increase the percentage of commuters that cycle to

work or education in Copenhagen to 50% Reduce by 50 % the number of seriously injured

cyclists

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Department of Public Health

Purpose of the study

Dual purpose:

- Estimate the health effect of increased commuting by bicycle in and out of Copenhagen Shift commuters from passive to active transport Both positive and negative effects

- Health Impact Assessment as a decision making tool in Danish municipalities Increasing interest in HIA in Denmark Focus on quantification in effect estimation

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Methods used in the study

Screening

Scoping

Effect analysis

Reporting

Monitoring and evaluation

Policy, project or programme

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Screening

Screening

Scoping

Effect analysis

Reporting

Monitoring and evaluation

Is it relevant to perform an HIA?

Policy, project or programme

Screening tool

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Scoping (1)

Screening

Scoping

Effect analysis

Reporting

Monitoring and evaluation

Selection of relevant determinants of health

Policy, project or programme

Selection of relevant health outcomes

Quantitative approach (Burden of Disease)

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Department of Public Health

Scoping (2)

Increased commuting by bicycleProject or plan

Air pollution

Physical inactivity

Health determinants

Health outcomes

Aggregated effect Changed burden of disease in the population of commuters

Changed incidence of ischemic hearth disease, ischemic stroke, type II diabetes, breast and colon cancer

Bicycle accidents

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Effect analysis

Screening

Scoping

Effect analysis

Reporting

Monitoring and evaluation

Policy analysis and baseline description

Estimation of effect on health determinants

Assessment of effect on health outcomes

Interpretation and formulation of recommendations

Policy, project or programme

Assessment of aggregated effect on health outcomes

Impact assessment

Outcome assessment

Aggregation

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Main results of effect analysis

- Analyses of different scenarios 50% bicycle commuting:

• Reduction of 17 DALY (1,3%) 50% bicycle commuting + no increase in number of

bicycle accidents:• Reduction of 54 DALY (4,1%)

50% bicycle commuting + no increase in number of accidents + shift of physically inactive commuters:• Reduction of 151 DALY (11,4%)

Very limited effect of air pollution

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Reporting

Screening

Scoping

Effect analysis

Reporting

Monitoring and evaluation

Policy, project or programme

Report and disseminate knowledge of results and recommendations

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Conclusion and recommendations

- Shifting commuters to go by bicycle has potential to lower the burden of disease in the population

- Conditions for achieving positive health impacts of bicycle commuting:

Reduce effect of bicycle accidents• Reduce number and severity of accidents

Achieve maximum change in exposure• Shift physically inactive commuters

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Thank you for your attention