The Health Economic Case for Infrastructure to Promote Active Travel: A Critical Review

The aim of this paper is to review the current state of the economic evaluation evidence concerning infrastructural environmental interventions for walking and cycling and their health benefits. Relevant economic evaluations are identified by applying inclusion and exclusion criteria to the results of a search of health, social science, transport and built environment literature databases. Approaches to economic evaluation used in the included studies are analysed and the main economic findings of the studies summarized. The findings and synthesis of this critical review point to areas of commonality in the approaches to economic evaluation, conceptualization of costs and benefits and measures of economic effectiveness, the findings of the studies and their implications for policy. The review shows that while studies often adopt similar approaches to the generation of economic effectiveness evidence for walking and cycling infrastructure, the methods used to measure and value health benefits and the range of benefit-cost ratios estimated are diverse. The review concludes that further development beyond traditional approaches to economic evaluation of walking and cycling schemes is desirable.