Jacob Verughese, Chattopadhyay Sajal K, Reynolds Jeffrey A, Hopkins David P, Morgan Jennifer A, Brown David R, Kochtitzky Christopher S, Cuellar Alison E, Kumanyika Shiriki K
Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia.
Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Prev Med. 2021 Jan;60(1):e27-e40. doi: 10.1016/j.amepre.2020.08.002.
The number of children who bicycle or walk to school has steadily declined in the U.S. and other high-income countries. In response, several countries responded in recent years by funding infrastructure and noninfrastructure programs that improve the safety, convenience, and attractiveness of active travel to school. The objective of this study is to synthesize the economic evidence for the cost and benefit of these programs.
Literature from the inception of databases to July 2018 were searched, yielding 9 economic evaluation studies. All analyses were done in September 2018-May 2019.
All the studies reported cost, 6 studies reported cost benefit, and 2 studies reported cost effectiveness. The cost-effectiveness estimates were excluded on the basis of quality assessment. Cost of interventions ranged widely, with higher cost reported for the infrastructure-heavy projects from the U.S. ($91,000-$179,000 per school) and United Kingdom ($227,000-$665,000 per project). Estimates of benefits differed in the inclusion of improved safety for bicyclists and pedestrians, improved health from increased physical activity, and reduced environmental impacts due to less automobile use. The evaluations in the U.S. focused primarily on safety. The overall median benefit‒cost ratio was 4.4:1.0 (IQR=2.2:1-6.0:1, 6 studies). The 2-year benefit-cost ratios for U.S. projects in California and New York City were 1.46:1 and 1.79:1, respectively.
The evidence indicates that interventions that improve infrastructure and enhance the safety and ease of active travel to schools generate societal economic benefits that exceed the societal cost.
在美国和其他高收入国家，骑自行车或步行上学的儿童数量一直在稳步下降。作为回应，近年来，一些国家通过资助基础设施和非基础设施项目来做出反应，这些项目提高了步行或骑行上学的安全性、便利性和吸引力。本研究的目的是综合这些项目成本和效益的经济证据。
检索了从数据库建立之初到2018年7月的文献，共获得9项经济评估研究。所有分析均在2018年9月至2019年5月进行。
所有研究都报告了成本，6项研究报告了成本效益，2项研究报告了成本效果。基于质量评估，成本效果估计被排除。干预措施的成本差异很大，美国（每所学校91,000 - 179,000美元）和英国（每个项目227,000 - 665,000美元）的基础设施密集型项目报告的成本较高。效益估计在对骑自行车者和行人安全性的改善、身体活动增加带来的健康改善以及汽车使用减少对环境影响的降低等方面存在差异。美国的评估主要集中在安全性上。总体效益成本中位数比为4.4:1.0（四分位间距 = 2.2:1 - 6.0:1，6项研究）。美国加利福尼亚州和纽约市项目的两年效益成本比分别为1.46:1和1.79:1。
证据表明，改善基础设施以及提高步行或骑行上学的安全性和便利性的干预措施产生的社会效益超过了社会成本。
