Sustainable Urban Transport 9781784416157, 9781784416164

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SUSTAINABLE URBAN TRANSPORT

TRANSPORT AND SUSTAINABILITY Series Editors: Stephen Ison and Jon Shaw Recent Volumes: Volume 1:

Cycling and Sustainability

Volume 2:

Transport and Climate Change

Volume 3:

Sustainable Transport for Chinese Cities

Volume 4:

Sustainable Aviation Futures

Volume 5:

Parking Issues and Policies

Volume 6:

Sustainable Logistics

TRANSPORT AND SUSTAINABILITY VOLUME 7

SUSTAINABLE URBAN TRANSPORT EDITED BY

MARIA ATTARD University of Malta, Msida, Malta

YORAM SHIFTAN

Technion
Israel Institute of Technology, Haifa, Israel

United Kingdom
North America
Japan India
Malaysia
China

Emerald Group Publishing Limited Howard House, Wagon Lane, Bingley BD16 1WA, UK First edition 2015 Copyright r 2015 Emerald Group Publishing Limited Reprints and permissions service Contact: [email protected] No part of this book may be reproduced, stored in a retrieval system, transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise without either the prior written permission of the publisher or a licence permitting restricted copying issued in the UK by The Copyright Licensing Agency and in the USA by The Copyright Clearance Center. Any opinions expressed in the chapters are those of the authors. Whilst Emerald makes every effort to ensure the quality and accuracy of its content, Emerald makes no representation implied or otherwise, as to the chapters’ suitability and application and disclaims any warranties, express or implied, to their use. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN: 978-1-78441-616-4 ISSN: 2044-9941 (Series)

ISOQAR certified Management System, awarded to Emerald for adherence to Environmental standard ISO 14001:2004. Certificate Number 1985 ISO 14001

CONTENTS LIST OF CONTRIBUTORS

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TRANSPORT AND SUSTAINABILITY EDITORIAL BOARD

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ACKNOWLEDGEMENTS

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PREFACE

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CHAPTER 1 SUSTAINABLE URBAN TRANSPORT
AN INTRODUCTION Maria Attard and Yoram Shiftan

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CHAPTER 2 THE ECONOMIC ASSESSMENT OF HEALTH BENEFITS OF ACTIVE TRANSPORT Elisabete Arsenio and Paulo Ribeiro

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CHAPTER 3 MODE DECISIONS AND CONTEXT CHANGE
WHAT ABOUT THE ATTITUDES? A CONCEPTUAL FRAMEWORK Annika Busch-Geertsema and Martin Lanzendorf

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CHAPTER 4 THE INFLUENCE OF PARENT’S PERCEPTIONS AND RESIDENTIAL SELF-SELECTION TO THE CHILDREN’S TRAVEL MODES AT SINGLE PARENT HOUSEHOLDS Yusak O. Susilo

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CHAPTER 5 CHILDREN’S INDEPENDENT MOBILITY IN ISRAEL: CASE STUDY OF THE ARAB POPULATION GROUP Wafa Elias

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CONTENTS

CHAPTER 6 THE MALTA BUS SERVICE REFORM: IMPLICATIONS FOR POLICY FROM A ‘NATURAL EXPERIMENT’ OF ATTITUDES TOWARDS BUS SERVICE QUALITY AND MODAL SHIFT The´re`se Bajada

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CHAPTER 7 FURTHER RESEARCH INTO USING GEOGRAPHIC PRINCIPLES TO ANALYZE PUBLIC TRANSPORTATION IN THE USA AND MAXIMIZE THE CONCEPT OF INDUCED TRANSIT Richard D. Quodomine

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CHAPTER 8 UNDERSTANDING MULTIMODAL AND INTERMODAL MOBILITY Helga Jonuschat, Korinna Stephan and Marc Schelewsky

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CHAPTER 9 WHO WOULD USE INTEGRATED SUSTAINABLE MOBILITY SERVICES
AND WHY? Daniel Hinkeldein, Robert Schoenduwe, Andreas Graff and Christian Hoffmann

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CHAPTER 10 CAR SHARING SYSTEMS AS A SUSTAINABLE TRANSPORT POLICY: A CASE STUDY FROM LISBON, PORTUGAL Patrı´cia Baptista, Sandra Melo and Catarina Rolim

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CHAPTER 11 ANALYSIS OF EFFECTS RESULTING FROM IMPROVED VEHICLE FUEL EFFICIENCY AND FUEL PRICE CHANGES APPLIED TO THE BERLIN CITY NETWORK Arne Ho¨ltl, Matthias Heinrichs and Cathy Macharis

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ABOUT THE AUTHORS

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INDEX

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LIST OF CONTRIBUTORS Elisabete Arsenio

LNEC Department of Transport, Lisbon, Portugal

Maria Attard

University of Malta, Msida, Malta

The´re`se Bajada

University of Malta, Msida, Malta

Patrı´cia Baptista

IDMEC, Instituto Superior Te´cnico, Universidade de Lisboa, Portugal

Annika BuschGeertsema

Goethe University Frankfurt, Germany

Wafa Elias

Shamoon College of Engineering, Israel

Andreas Graff

InnoZ
Centre for Innovation in Mobility and Societal Change, Berlin, Germany

Matthias Heinrichs

German Aerospace Center (DLR), Institute of Transport Research, Germany

Daniel Hinkeldein

InnoZ
Centre for Innovation in Mobility and Societal Change, Berlin, Germany

Christian Hoffmann

InnoZ
Centre for Innovation in Mobility and Societal Change, Berlin, Germany

Arne Ho¨ltl

Vrije Universiteit Brussel, Research group MOBI, Belgium

Helga Jonuschat

InnoZ
Centre for Innovation in Mobility and Societal Change, Berlin, Germany

Martin Lanzendorf

Goethe University Frankfurt, Germany

Cathy Macharis

Vrije Universiteit Brussel, Research group MOBI, Belgium

Sandra Melo

IDMEC, Instituto Superior Te´cnico, Universidade de Lisboa, Portugal vii

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LIST OF CONTRIBUTORS

Richard D. Quodomine

New York State Department of Transportation, USA

Paulo Ribeiro

Universidade do Minho, Campus de Gualtar, Braga, Portugal

Catarina Rolim

IDMEC, Instituto Superior Te´cnico, Universidade de Lisboa, Portugal

Marc Schelewsky

InnoZ
Centre for Innovation in Mobility and Societal Change, Berlin, Germany

Robert Schoenduwe

Goethe University Frankfurt, Germany

Yoram Shiftan

Technion, Haifa, Israel

Korinna Stephan

InnoZ
Centre for Innovation in Mobility and Societal Change, Berlin, Germany

Yusak O. Susilo

KTH Royal Institute of Technology, Stockholm, Sweden

TRANSPORT AND SUSTAINABILITY EDITORIAL BOARD Maria Attard University of Malta, Malta

Robert B. Noland Rutgers University, USA

Lucy C. S. Budd Loughborough University, UK

Dr. Joachim Scheiner Technische Universita¨t Dortmund, Germany

Becky Loo Hong Kong University, Hong Kong

Joe Zietsman Texas A&M Transportation Institute, USA

Corinne Mulley The University of Sydney Business School, Australia

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ACKNOWLEDGEMENTS We are thankful to Emerald for publishing this volume. We wish to thank Cristina Irving Turner for her support and the Series Editors Prof. Stephen Ison and Prof. Jon Shaw for their assistance. We also appreciate the efforts of our external reviewers who provided extremely helpful feedback on each chapter. We thank our authors for contributing to this volume and bearing with us during the course of the work. We believe that sustainable urban transport will become a reality in the near future and that through this volume we are contributing to that reality. Maria Attard and Yoram Shiftan

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PREFACE As the world population becomes more urban and our cities experience challenges with increasing pressures for supporting infrastructures, the issues with urban transport become even more critical. Transport not only provides accessibility for individuals to reach jobs, leisure activities, and other opportunities, but also ensures there is effective distribution of goods and services. This however has come at a price, especially in urban areas. Increased awareness and stricter environmental targets are driving cities to be bold in their approaches toward sustainable transport. It is this drive that sees many projects and related research developing in this direction. This book presents a selection of chapters on the theme of sustainable urban transport. The contributions were first presented at the 2013 NECTAR Conference at the University of the Azores, which brought together over 100 scholars from around the world. The International Conference, entitled Dynamics of Global and Local Networks, included eight special sessions. This book represents a selection of papers from the sessions organized by Cluster 1: A Future for Non-Motorized Transport Modes: Walking and Cycling Networks, and Cluster 2: Policy and Environment. We hope that the book will be beneficial to practitioners primarily, but also to researchers and students of urban studies, transport management, and policy. This book aims to contribute knowledge that will help meet the targets and challenges for sustainable urban transport. Maria Attard (Malta) Yoram Shiftan (Israel)

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CHAPTER 1 SUSTAINABLE URBAN TRANSPORT
AN INTRODUCTION Maria Attard and Yoram Shiftan INTRODUCTION As more people choose to live in urban areas, a key element for the success and sustainability of cities is a transport system that is able to meet the needs for economic growth and at the same time care for the environment and people’s quality of life. This is challenged by the positive contributions of transport to society in terms of opportunities for employment, education and leisure, and at the same time the high costs associated with pollution, congestion, traffic crashes, noise and other externalities. Sustainable urban transport is an attempt to contribute positively to communities and their built environments. Environmentalists, policy makers and planners have used the term sustainability for many years now and it is a term that has come to embrace concerns about the social, as well as the physical environment. These concerns range from the immediate and short-term
such as health, road safety and social exclusion
to the very long-term
such as the security of energy supplies and climate change. In the absence of convergence on an agreed meaning for the term, sustainability or sustainable has come to be

Sustainable Urban Transport Transport and Sustainability, Volume 7, xv
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used rather loosely as an adjective that is applied to projects or policies that are judged to be less harmful than those that they are replacing. Trends and policies that are unsustainable are easier to recognize than those that are definitely sustainable
particularly given the technical and scientific uncertainties about the future. In addition to concerns about atmospheric pollution in urban areas and climate change, a great number of other concerns have emerged in recent years to which the term has been applied (Zachariadis, 2005). For some time now one of the major issues on the sustainability agenda has been transport (see early documents such as EEA, 2002; European Commission [EC], 2001, 2004; IEA 2002; WBCSD, 2001; World Bank, 1996). Wegener and Greene (2002) identified three main threats from the unsustainable growth of motorized transport. These are: • the degradation of the local and global environment; • consumption of non-renewable resources that appear to be essential to the quality of life of future generations; and • institutional failures that exacerbate the previous two problems (e.g. traffic congestion, which increases pollution and fuel consumption but also generates demand for more infrastructure and its consequences, such as further urbanization of land and still more vehicle travel). In Europe alone some 40,000 people are killed in traffic crashes every year and congestion has been estimated to cost around h120 billion (EC, 2006). According to the International Energy Agency (IEA) (2009), nearly a quarter of CO2 emissions contributing to climate change originate from transport activities. In Europe, this corresponded to 29.9% of the total CO2 emissions (EC, 2012). Efforts to lessen the contribution of pollution have come mainly from technology, with more money being invested than ever before in alternative technologies that pollute less. However, whilst technological innovations may help tackle certain environmental problems, the damage caused by the intrusion of infrastructure and vehicles into neighborhoods and communities cannot be addressed so easily. Jacobs (1961) referred to the destructive effect of the car “replacing, in effect, each horse on the crowded city streets with half a dozen or so mechanised vehicles, instead of using each mechanised vehicle to replace half a dozen or so horses. The mechanical vehicles, in their overabundance work slothfully and idle much. As one consequence of such low efficiency, the powerful and speedy vehicles, choked by their own redundancy, don’t move much faster than horses.”

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DEFINITIONS OF SUSTAINABLE MOBILITY In April 2001 the European Commission defined sustainable mobility in its thematic strategy on the urban environment (EC, 2004). This communication identified unsustainable trends in urban areas and recognized that traffic has had significant impacts on the environment and health of urban citizens and the overall quality of life in towns. This concern also came from earlier debates about sustainable transport that remained unresolved in the Organisation for Economic Co-operation and Development’s (OECD) Environmentally Sustainable Transport (EST) project (OECD, 1999). The Project noted the close and durable correlation between economic growth and traffic growth, and observed that there was a need “for exploration of the concept of ‘uncoupling’ (decoupling) of transport activity and economic activity and its relevance to sustainability.” This was a problem that Britain’s Royal Commission on Environment Pollution also wrestled with in its 1994 report entitled “Transport and the Environment.” This report raised the profile of transport problems, stating that “the unrelenting growth of transport has become possibly the greatest environmental threat facing the UK, and one of the greatest obstacles to achieving sustainable development” (Royal Commission on Environmental Pollution, 1994). The first objective of a sustainable transport policy, it stated, should be to integrate transport policy with land use policy and give priority to minimizing the need for transport. But, like the later efforts of the EU and the OECD, it weakened the force of this objective by setting it in the context of the need to strike the right balance between the ability of transport to serve economic development and the ability to protect the environment. The report also placed a strong emphasis on the importance of a shift to less environmentally damaging modes of transport. Sustainable mobility is an aspirational term that calls attention to the need to shift away from the traditional transport planning approach, which conceptualizes transport as a derived demand and as a support infrastructure for economic growth, towards a policy approach that is informed by evidence and risk assessment and which recognizes the pitfalls of unconstrained growth (Giorgi, 2003). Today, although the sustainable mobility discourse is playing an increasingly important role in debates about transport and mobility, there is still too little to show by way of achievement. Transport demand continues to increase with no signs of “decoupling” from economic growth. The reluctance of public administrations to invest in sustainable mobility measures has tended to aggravate the situation,

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with most politicians seeming to prefer environmental suicide to what they consider would be an act of political suicide, if they were to attempt to implement such measures (Adams, 1994). In addition to this, the relative strength of air and road lobbies vis-a`-vis the much weaker representatives of public transport, walking, cycling and waterborne interests has contributed further to the difficulties of implementing sustainable mobility. Sustainable mobility as a vision or aspiration, on the other hand, is effecting a change of thinking by some policy makers and key stakeholders. Goals like environmental protection and ideas like participatory democracy, which were foreign to the minds of transport planners not so long ago, are now establishing themselves on the transport policy agenda. Despite this, there is still a need for some guiding principles, if sustainability is to become more than green rhetoric. It is evident that there is a need for change in the way transport policy is formulated and implemented, with the European Union having the potential, in principle, through the concept of subsidiarity to help local governments to pursue local priorities.

SUSTAINABLE MOBILITY IN THE EUROPEAN CONTEXT The European Common Transport Policy has its origins in the 1957 Treaty of Rome to oversee primarily the requirements for intra-Community transport, to permit free movements of goods, services, capital, and labor. Between 1957 and 1991, the Common Transport Policy did not amount to much more than the stated intention to facilitate transport between the Member States. The 1992 White Paper entitled “The Future Development of the Common Transport Policy” followed as the next major development in European Transport Policy (European Communities, 1993). This included a set of objectives to be achieved by the Common Transport Policy relating to sustainability and social cohesion. More specifically it called for: • the continued reinforcement and proper functioning of the internal market, facilitating the free movement of goods and persons throughout the Community; • a transition from regulation towards the adoption of balanced policies favoring the development of integrated transport systems for the Community as a whole using the best available technology;

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• the strengthening of economic and social cohesion by the development of transport infrastructure to reduce disparities between the regions and to link peripheral regions with the central regions of the Community; • measures to ensure that the development of transport systems contributed to a sustainable pattern of development by respecting the environment and, in particular, by contributing to the solution of major environmental problems such as the limitation of CO2; • actions to promote safety; • measures in the social field; and • the development of appropriate relations with third countries, where necessary giving priority to those for which the transport of goods, or persons is important for the Community as a whole (Schmidt & Giorgi, 2001). A major criticism of the 1992 White Paper was its failure to define sustainable mobility. It went only as far as to say that the tools for achieving it are efficient, safe transport under the best possible environmental and social conditions. It is a statement which could also reflect efforts by society and the economy, without much disruption to current practices. During the 1990s, the Commission sought to take up a coordinating role in financing research and diffusing best-practice experience in the various sectors, including urban transport. Subsequently, the White Paper published in September 2001, “European Transport Policy for 2010: Time to Decide” (EC, 2001), was more comprehensive, outlining explicitly for the first time the Commission’s diagnosis of the problems at hand and their interrelations, and also proposing solutions. The main elements of the White Paper were: • • • •

Shifting the balance between modes of transport Eliminating bottlenecks Placing users at the heart of transport policy Managing the globalization of transport

The Community initiatives on urban transport were eventually summarized in the Communication entitled “Towards a thematic strategy on the urban environment” published in 2004 referred to earlier. The 2006 review of the EU Transport White Paper entitled “Keep Europe Moving: a transport policy for sustainable mobility” set the future transport policy for the Union. In this review, additional instruments were proposed to achieve sustainable mobility (EC, 2006). Amongst these was the promotion of a debate on how to change mobility of people in urban

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areas. The 2011 White Paper entitled “Roadmap to a Single European Transport Area. Towards a Competitive and Resource Efficient Transport System” continued to reinforce these principles and advocating a modal shift in both passenger and freight transport (for further discussion see Ponti, Boitani, & Ramella, 2013). Despite this, Go¨ssling and Cohen (2014) contend that even though the Commission targets an emission reduction from transport of 60% by 2050 with an interim goal of 20% by 2030, it also states that “curbing mobility is not an option” (EC, 2011a). This legislative objective conflicts with the opinions of many who have, over the years, stated that for emissions to reduce, energy-intensive forms of mobility will have to reduce (see, e.g. Anable, Brand, Tran, & Eyre, 2012; Banister, 2008; Chapman, 2007; Dubois, Ceron, Peeters, & Go¨ssling, 2011; IEA, 2012). In parallel to this work the Commission also published an “Action plan on Urban Mobility” in 2009 (EC, 2009) recommending the adoption of Sustainable Urban Mobility Plans. In 2010, the Council supported this initiative and the 2011 White Paper proposed that there might be a mandatory approach for such Plans for cities of a certain size, and that the allocation of regional development and cohesion funds might be made conditional on the submission and auditing of such Plans (EC, 2011b). In support of this the ELTISplus project developed guidance (Eltisplus, 2014) and set up an urban mobility observatory to facilitate the exchange of information, knowledge and experiences in the field of sustainable urban mobility in Europe (http://www.eltis.org). This introduction sets the scene for the remaining chapters in the book that aim to contribute to the various discussions in the complexity of implementing sustainable urban transport. These chapters present a series of studies undertaken in support of sustainable urban transport, in Europe and beyond looking at issues of non-motorized modes and health benefits, behavioral changes, children travel, public transport and various new mobility services, as well as new technologies such as driver assistance systems. While it is impossible to cover the wide spectrum of sustainable urban issues in one volume, the collection of chapters in this book provide a wide overview of the various issues contributing to sustainable urban transport development.

Outline of the Book A number of aspects dealing with the more current and pressing concerns in sustainable urban transport are discussed in this book. This is done through a series of studies that look at various cases and locations.

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In Chapter 1, Arsenio and Ribeiro discuss active travel and the economics of the respective health benefits. The chapter provides a useful review of the health benefits of walking and cycling and assesses the appraisal tools currently used for walking and cycling investments. It uses the city of Viana do Castelo in Portugal as a case study and behavioral data to assess the impact of an intervention on a street in the historic city center. The chapter contributes to the current discussions on appraisal tools and the need to re-shape cities for better health through investment in project that promote active travel. In appreciating the importance of active travel and the need for proper appraisal mechanisms in support of such interventions, Busch-Geertsema and Lanzendorf, in Chapter 2 of this book, deal with modal choice and behavior change, looking at key life events that provide the opportunity for travel behavior change. They propose a new framework whereby habitual travel behavior could be weakened and broken by key life events, following an understanding of the relevant factors that affect travel mode choice. In this case, they apply the requirements, opportunities and abilities (ROA) model proposed by Harms (2003). Susilo in Chapter 3 presents a study on children’s travel modes and contributes to the on-going discussion in this field by looking at single parent households and the impact of parent’s perceptions and residential location. Results of his study show how parent’s perceptions play a significant role in the child’s travel behavior, whilst residential location has an impact primarily on the parent’s mode choice. This UK-based study is relevant in the context of the ever-present number of single parent households in cities and their contribution to urban transport. Studying children’s mobility is of particular interest to the sustainability discussion since it is important to focus on today’s children in order to change the future. Habits and behaviors, which are observed in childhood, have lasting implications on the health of the child as well as future travel behavior. In Chapter 4, Elias investigates children’s independent mobility using a case study of the Arab population in Israel. She investigates the factors influencing children’s journey to school with the objective to inform policies and campaigns aimed at promoting walking and cycling to school amongst children in Israel. The next two chapters focus on public transport systems, which are the main critical infrastructures that support sustainable urban travel. To this end, Chapter 5, by Bajada focuses on the importance of bus service quality in influencing perception, attitude and ultimately use of public transport services. She uses the example of the bus reform that revolutionized the provision of bus services in the island state of Malta. Her study focuses on

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residents of the islands and their perception of quality as an indicator of potential modal shift. In an island plague with high levels of motorization and car dependence, studies that provide an insight into possible effects of reforms are very important. Cities, similar in size and geography would benefit from such studies. Quodomine in Chapter 6 discusses the provision and availability of public transport services using examples from the New York Area in the United States. This chapter describes the population characteristics that have defined public transport users in the United States over the last decades. Quodomine then maps these characteristics and through the use of Geographic Information Systems (GIS) develops opportunities for “new” public transport services and users. The study attempts to provide planners and policy makers with tools, data and methods that are readily available to support planning for public transport services. In addition to traditional public transport, cities are now seeing the emergence of new mobility services. These services include an array of alternative and often multi-modal transport services, some of which are highly organized, others less so. Three chapters in this book discuss these new mobility services, in particular they tackle various aspects related to user behavior of these new services. Jonuschat, Stephan, and Schelewsky in Chapter 7 describe the array of multi-modal “shared” transport services available in many cities today. They analyze user perspective on intermodality and identify characteristics which help in planning and designing car independent cities. On the other hand, Hinkeldein, Schoenduwe, Graff and Hoffmann in Chapter 8 study the user requirements and attitudes towards services that integrate electric vehicles in shared mobility services and public transport. Four German cities (Berlin, Frankfurt, Hamburg and Munich) were surveyed to establish the user types, based on travel behavior, which would support specific strategies for encouraging urban e-mobility services. Whilst Hinkelein et al. focus on German examples, Baptista, Melo, and Rolim in Chapter 9 focus specifically on the case study of Lisbon. Following an extensive review of car sharing scheme in Europe and the world, they analyze the energy and environmental impact of car sharing technology shifts, as well as the total car sharing impacts and the policy implications in Lisbon. The last chapter of this volume, Chapter 10, presents work by Ho¨ltl, Heinrichs, and Macharis who look at improved vehicle efficiency through technologies such as driver assistance systems. Once again the city of Berlin is used as a case study through which simulations are run to establish the effects of vehicle efficiency gains and any rebound effects from improved

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efficiency. These results are particularly interesting for those planning and estimating efficiency gains at city network level.

CONCLUSIONS This volume presents a mix of studies and cases, which in their own right constitute wide areas of research. The common thread between all the chapters shows more than anything, the efforts being made at the city level to achieve sustainable transport. It also shows the complexity associated with achieving such an objective. Differences in behavior and lifestyles, brought about by geography and culture, have a significant impact on the way people move and travel. The chapters presented in this volume also demonstrate the need for an integrated and concerted effort to adopt the principles of sustainability in urban transport and gradually and steadily implement policies and measures that have a long lasting effect on the negative externalities. A change in discourse, as well as action, is required to ensure that sustainable urban transport is truly successful. This integrated approach should consider a mix of measures including promoting non-motorized transport and public transport as well as various new mobility services such as car and bike sharing. It should also include a better understanding of how policy makers can better encourage behavioral change towards sustainable travel. Various specific conclusions and recommendations in this direction are suggested throughout the chapters of this book. Arsenio and Ribeiro (Chapter 1) also show that further research is needed to integrate health benefits of active transport in cost benefit analysis, as including such benefits in transport appraisal show a high benefit to cost ratio. Recognizing these benefits can help local decision-makers to promote sustainable mobility plans and to raise awareness amongst the population. This can encourage them to include active transport as part of their daily activities. Busch-Geertsema and Lanzendorf (Chapter 2) suggest that a better understanding of the interaction between mobility-related attitudes and mode choice before and after key events can provide insights on how and when mobility management tools can persuade attitudes or affect behavior specifically in the phases of changing contexts in life or even before a key event starts. In promoting urban sustainable transport, it is important to give special attention to children’s travel as they contribute a large share of the daily

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travel done by households. Children will also be the adults of the future and therefore have a long-term impact on the future mobility of cities. To achieve a higher share of active transport amongst children Susilo (Chapter 3) suggests involving parents in promoting the active transport of their children based on his findings of the important role parents’ perceptions have on the travel mode adopted subsequently by children. Elias (Chapter 4) further emphasizes the importance of the built environment and of education with respect to the benefits of active travel to promote walking and cycling amongst children. Improving public transport service quality and perception is a key in promoting modal shift from car to sustainable modes, and Bajada (Chapter 5) summarizes the main policy recommendations in this direction including auto restrain policies, more integrated public transport systems, including park and ride facilities and improved information, and the promotion of smarter choices. Quodomine (Chapter 6) emphasizes the importance of understanding the distribution of the population sociodemographics and needs in planning intelligent transit services, and extend services to populations who have the potential to use it, but have no such services today. Jonuschat et al. (Chapter 7), Hinkeldein et al. (Chapter 8) and Baptista et al. (Chapter 9) all emphasize the growing contribution of new mobility services such as car and bike share, and the role of smartphone applications in making them more available and efficient. Jonuschat et al. emphasize their contribution to multi-modal travel and sustainable transport. They specifically show the advantages and potential of car sharing trips to public transport stations to replace car trips all the way to the destination. Hinkeldein et al. identify three market segments in the population that are most likely to use such services and therefore should be a main target for operators and local planning agencies in developing the services. Finally, Baptista et al. show that for the case study of Lisbon, energy consumption and CO2 emission can decrease up to 47% and 65% respectively by shifting to electric mobility technologies. Finally, Ho¨ltl et al. (Chapter 10) suggest the contribution of driver assistance systems in reducing fuel consumption and emissions; however, they also show how rebound effects can reduce by roughly a tenth, the intended savings. Throughout the various chapters, it is evident that perception and awareness seems to play an important role in promoting sustainable travel choices. Awareness of the health benefits of non-motorized modes promote their use (Arsenio and Ribeiro, Chapter 1), parents’ perceptions affect their children’s travel mode (Susilo, Chapter 3) and the perception about the

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built environment has an important role on children’s active travel (Elias, Chapter 4). Bajada (Chapter 5) shows the importance of bus service quality in influencing perception, attitude and ultimately use of public transport services, and Jonuschat et al. (Chapter 7) analyze the user perspective on inter-modality and new mobility services. Another theme that arises throughout the various chapters of the book is the need to tailor services to specific populations, as Quodomine (Chapter 6) suggests to tailor transit services according to the distribution of the population socio-demographics and needs, and Hinkeldein et al. (Chapter 8) identify target groups for shared electric vehicle programs focusing on user requirements and attitudes. Overall, the book shows various examples of how it is possible to influence travel behavior, design more efficient transport modes, design better urban environments that encourage more walking and cycling, and create new, high-quality services that provide alternatives to the car. Research in sustainable urban transport is and will be required to ensure a better understanding of processes that affect our daily patterns and the impact they have on the urban infrastructure and environment. Research also ensures the promotion of successful policy (best practice) and to a certain extent knowledge and policy transfer.

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European Commission. (2006). Keep Europe moving: Sustainable mobility for our continent. Directorate-General for Mobility and Transport. Brussels: European Commission. European Commission. (2009). Action plan on urban mobility. Directorate-General for Transport and Energy. Brussels: European Commission. European Commission. (2011a). Commission staff working document. Accompanying the White Paper ‘Roadmap to a single European transport area: Towards a competitive and resource efficient transport system’, COM (2011) 144 final. Brussels: European Commission. Retrieved from http://eur-lex.europa.eu/legal-content/EN/TXT/PDF/? uri=CELEX:52011SC0391&from=EN European Commission. (2011b). Roadmap to a single European transport area: Towards a competitive and resource efficient transport system. White Paper, COM (2011) 144 final. Brussels: European Commission. Retrieved from http://ec.europa.eu/transport/themes/ strategies/2011_white_paper_en.htm European Commission. (2012). EU transport in figures. Statistical Pocketbook 2012. Retrieved from http://ec.europa.eu/transport/facts-fundings/statistics/doc/2012/pocket book2012.pdf European Communities. (1993). The future development of the common transport policy. A global approach to the construction of a Community framework for sustainable mobility. White Paper COM(92)494 Final. Retrieved from http://aei.pitt.edu/1116/1/ future_transport_policy_wp_COM_92_494.pdf Giorgi, L. (2003). Sustainable mobility. Challenges, opportunities and conflict: A social science perspective. International Social Science Journal, 55, 179
183. Go¨ssling, S., & Cohen, S. (2014). Why sustainable transport policies will fail: EU climate policy in the light of transport taboos. Journal of Transport Geography, 39, 197
204. Harms, S. (2003). Besitzen oder Teilen: Sozialwissenschaftliche Analyse des Carsharings. Zu¨rich: Ru¨egger. International Energy Agency. (2002). World energy outlook 2002. Paris: IEA. International Energy Agency. (2009). Transport, energy and CO2: Moving towards sustainability. Paris: IEA. International Energy Agency. (2012). World energy outlook 2011. Paris: IEA. Jacobs, J. (1961). The death and life of great American cities. New York, NY: Penguin. Organisation for Economic Co-operation and Development. (1999). Project on Environmentally Sustainable Transport (EST). Paris: Environment Directorate, OECD. Ponti, M., Boitani, A., & Ramella, F. (2013). The European transport policy: Its main issues. Case Studies in Transport Policy, 1, 53
62. Royal Commission on Environmental Pollution. (1994). Transport and the environment, eighteenth report. London: HMSO. Schmidt, M., & Giorgi, L. (2001). Successes, failures and prospects for the common transport policy. Innovation, 14, 293
313. WBCSD. (2001). Mobility 2001. World mobility at the end of the twentieth century and its sustainability. Geneva: World Business Council for Sustainable Development. Retrieved from http://www.wbcsdmobility.org/publications/mobility2001.asp Wegener, M., & Greene, D. L. (2002). Sustainable transport. In W. R. Black & P. Nijkamp (Eds.), Social change and sustainable transport. Bloomington, IN: Indiana University Press. World Bank. (1996). Sustainable transport: Priorities for policy reform. Washington, DC: World Bank. Retrieved from http://www.world-bank.org/transport/pol_econ/tsr.htm Zachariadis, T. (2005). Assessing policies towards sustainable transport in Europe: An integrated model. Energy Policy, 33, 1509
1525.

CHAPTER 2 THE ECONOMIC ASSESSMENT OF HEALTH BENEFITS OF ACTIVE TRANSPORT Elisabete Arsenio and Paulo Ribeiro ABSTRACT Purpose
This chapter addresses the economic assessment of health benefits of active transport and presents most recent valuation studies with an overview of progresses made towards the inclusion of health benefits in the cost-benefit analysis (CBA) of active transport. Methodology/approach
It is built upon the contracted study for the World Health Organization (WHO) on the economic appraisal of health benefits of walking and cycling investments at the city of Viana do Castelo, the former pilot study in Portugal for evaluating the health benefits of non-motorized transport using the WHO Health Economic Assessment Tool (HEAT). The relative risk values adopted in the HEAT for walking refer to adult population of the age group 20
74 years and the assessment focus in on average physical activity/regular behaviour of groups of pedestrians and all-cause mortality health impacts. During the case study, it was developed and implemented a mobility survey which aimed to collect behavioural data before and after a street intervention in the historic centre.

Sustainable Urban Transport Transport and Sustainability, Volume 7, 1
22 Copyright r 2015 by Emerald Group Publishing Limited All rights of reproduction in any form reserved ISSN: 2044-9941/doi:10.1108/S2044-994120150000007011

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Findings
Most recent appraisal guidance of walking and cycling and health impact modelling studies reviewed confirm that further research is expected before a more comprehensive appraisal procedure can be adopted in Europe, able to integrate physical activity effects along with other health risks such as those related to road traffic injuries and exposure to air pollution. Social implications
The health benefits assessment of walking investments helped local decision-makers to progress towards sustainable mobility options in the city. Making the population aware of the potential health benefits of regular walking can encourage more people to uptake active transport as part of their daily activities. Originality/value
This study provides a useful review of the health benefits of active transport with a comprehensive analysis of valuation studies, presenting value-added information. It then reports a former assessment of the health effects of active transport in the Portuguese context (case study) using the state-of-the-art economic analysis tool (HEAT) of the World Health Organization which is believed to contribute to a paradigm shift in the transport policy and appraisal practice given the need of shaping future cities (and their citizens) for health through more investments in active transport. Keywords: Sustainable transport; walking and cycling; health economic assessment tool; World Health Organization; health benefits; cost-benefit analysis

INTRODUCTION The link between physical activity and health is known since the 1950s (Morris, Heady, Raffle, Roberts, & Parks, 1953) and there is a body of research demonstrating that regular physical activity reduces the risk of various chronic health conditions and related diseases such as cardiovascular disease (CDV), cancer (colon, breast, lung), type-2 diabetes and mental health (Saunders, Green, Petticrew, Steinbach, & Roberts, 2013). The long-term health benefits of regular physical activity levels on health are well documented worldwide (US Department of Health and Human Services [USDHHS], 2008; WHO, 2010), but around 63% of adults

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(18
64 years old) do not reach the World Health Organization (WHO) recommended levels of physical activity for health. This should be at least 150 minutes of moderate-intensity aerobic physical activity through the week or at least 75 minutes of vigorous-intensity aerobic physical activity. In the world, physical inactivity is already the fourth leading risk factor for global mortality, being responsible for 3.2 million deaths annually (6% of deaths globally). Overweight and obesity is the fifth risk factor responsible for an additional of 2.8 million deaths annually (WHO, 2009). The WHO advocates that regular daily walking and cycling (active transport) can help to prevent deaths and reduce several health risks. Despite the above-mentioned evidence, non-motorized transport modes such as walking and cycling and their related health impacts have been often neglected in transport planning and appraisal, in comparison to motorized transport. In recent years, however, increased attention has been given to the health economic assessment of walking and cycling infrastructures using a cost-benefit analysis framework. Aiming to consider the most recent evidence on the relation of transport-related physical activity on health and state-of-the-art economic approaches, the WHO developed the Health Economic Assessment Tool (HEAT) and further guidance for Members States for the inclusion of health effects in economic analysis of walking and cycling infrastructures (WHO, 2011a). To demonstrate the capabilities of the HEAT for policy purposes, the HEPA Europe/Healthy Cities sub-network project group by the WHO Regional Office for Europe included the implementation of several case studies in Europe. This chapter is built around a former study in Portugal for evaluating the health benefits of active travel (Arsenio, Ribeiro, & Vieira, 2013): the WHO tool (HEAT) was applied to the city of Viana do Castelo, a medium-sized Portuguese city in the North of Portugal. The key research questions addressed within this chapter can be posed as follows: (a) If x people walk regularly a distance of y kilometres (or z minutes) on most days, what is the economic value of the correspondent health benefits? (b) Do health benefits of walking investments outweigh their costs? For using HEAT, the study included the collection of specific local-level data. It was developed and implemented a mobility survey targeting actual and potential pedestrians. The survey collected complementary data on perceived barriers and other factors that can influence a higher uptake of walking in the city. The methodology involved a close cooperation with the city policy makers and its technical staff members of several departments/ divisions (multidisciplinary team responsible for mobility planning, land use, social and environmental management and city’s sustainability) to

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whom an additional survey was delivered. This survey collected their views about the usefulness of the tool for transport policy purposes. The remainder of this chapter is organized as follows. The section ‘Health Benefits’ Assessment of Active Transport’ provides an overview of the benefits and costs of active transport and provides evidence on the relative magnitude of the health benefits and current appraisal practice. The third section ‘Assessing the Health Benefits of Walking in the City of Viana do Castelo’ presents the case study at the city of Viana do Castelo for assessing the health benefits of improving the urban public space for pedestrians which used ex ante and ex post mobility data related to a street reconstruction project. The last section concludes with a summary of contributions and policy implications.

HEALTH BENEFITS’ ASSESSMENT OF ACTIVE TRANSPORT Benefits and Costs of Active Transport The social appraisal of transport investment projects is theoretically founded in welfare economics and aims an efficient allocation of public resources (Brent, 1996). Since all public decisions have implications on the use of resources it is of utmost importance that current appraisal frameworks of non-motorized transport investments can provide precise information of the full range of benefits and costs to decision makers. Several reference studies and guidelines show that regular walking and cycling levels can have a range of potential benefits. The literature reveals several ways to categorize the economic impacts of active transport (Australian Government, 2012; Litman, 2013; Transportation Research Board [TRB], 2006; UKDfT, 2012). The increase of non-motorized transport activity (active transport levels) is associated to a range of potential effects which can be organized under the following impact categories: (a) Mobility and Access to Opportunities: increased door-to-door access to opportunities (economic activities, recreational activities, etc.), more convenience and comfort, improved accessibility for non-drivers (vertical equity), lower mobility costs (consumer costs) and so on. (b) Liveability/Community: more liveable and compact communities, option values for future use, community cohesion and social capital

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increase which also tends to increase local security (due to increased causal surveillance of the street), open space preservation, for example through walking and bicycle trails. (c) Environment (from reduced automobile travel): air-quality improvements in urban areas, reduction of traffic congestion levels (transfer of short-distance trips made by car to active transport), fossil fuel/non-renewable energy consumption reduction. (d) Road Safety: Reduction of road traffic accidents (road deaths, disabilities and injuries), positive impact on perceived levels of safety and crash risk and so on. (e) Health (Physical activity related): reduction of all-cause mortality, reduction of risk of specific diseases such as type 2 diabetes, ischaemic heart disease, etc., reduction of morbidity effects (absenteeism days due to sickness, etc.), government/health sector and business savings. Since some economic impacts may overlap it is important to avoid double-counting of benefits when including benefit components in the social cost-benefit analysis (SCBA) of non-motorized transport investments. The costs of walking and cycling infrastructures can be disaggregated into two major categories: capital costs (e.g. planning and project costs, construction and equipment expenditures to be amortized over the period of appraisal) and annual maintenance/operating costs (cleaning, landscaping, repair of equipment and route signs and so on). Overall, the capital costs of walking and cycling investments are much lower than for other transport modes. For example, in Australia, one kilometre of road costs (motorway) was found to be equivalent to 110 kilometres of bicycle lanes (QDoT, 2011; AUDoT, 2013). Maintenance costs of cycling facilities were found to be within the range of 0.04 AUS$cents/kilometre for concrete paths to 1.82 AUS$cents/kilometre for the case of asphalt paths (2010 constant prices in Australian dollars are equivalent, respectively, to 0.029 h/kilometre and 1.323 h/kilometre, using the average exchange rate for the same reference year). Appraisal tools such as social cost-benefit analysis can measure the magnitude of the range of economic impacts (social benefits and costs) associated with alternative transport investment options and help decision makers to choose the best option to society. As already noted by Mulley, Tyson, McCue, Rissel, and Munro (2013), the SCBA had historically developed continuously to include improved methodologies such as statedpreference based methods for evaluating non-priced effects of investments as information on its monetary values becomes available. Examples of

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various non-priced effects that have been integrated into SCBA are the value of travel time savings, value of reduced congestion, value of changes in accident risks and values of environmental externalities (e.g. traffic noise and air pollution). More recently, several studies give support to the inclusion of health benefits in the SCBA of walking and cycling investments (Cavill, Kahlmeier, Rutter, Racioppi, & Oja, 2008; NCM, 2005; Sælensminde, 2004; WHO, 2011b). However, as earlier noted by Woodcock, Givoni, and Morgan (2013), methods to estimate the health impacts from transport related physical activity and injury risk are still in their infancy.

Magnitude of the Health Effects of Active Transport Most valuation studies of the health benefits of active travel have been published over the recent years. Building upon the literature review of Genter, Donovan, and Petrenas (2008), one can see that different approaches had been used to value the health benefits of active transport modes (as part of a comprehensive SCBA) which accounted for different diseases’ costs, mortality and/or morbidity outcomes, using different monetary values (e.g. social costs for a set of diseases, value of a statistical life) and thresholds. Most recent studies used the World Health Organization’s appraisal tool (HEAT) or its parameter values to estimate the health benefits of increased physical activity of regular walking and cycling (Arsenio, Ribeiro, & Mendes, 2013; Grabow et al., 2012; Olabarria, Pe´rez, Santamarin˜a-Rubio, Novoa, & Racioppi, 2012). Since HEAT does not integrate injury and air pollution risks, more recent evidence is hereafter provided on the relative magnitude of physical activity health benefits. Rojas-Rueda, Nazelle, Tainio, and Nieuwenhuijsen (2011), who followed the WHO approach in the health economic assessment for cycling, found that the health benefits of Barcelona’s public bicycle rental system (Bicing) in Spain were larger than its risks (in relation to car driving): health benefits from improved fitness would correspond to 12.46 fewer deaths, whereas additional costs due to road traffic related mortality and air pollution, were found to be associated to 0.03 and 0.13 additional annual deaths, respectively. The benefit to risk ratio of the Barcelona bicycle rental scheme was found to be 77. Rojas-Rueda, Nazelle, Teixido´, and Nieuwenhuijsen (2013), in another study used eight transport scenarios and a health impact assessment approach to estimate morbidity related health impacts from reducing car trips as a result of shifts to public transport and cycling in Barcelona. The study found that the greatest health benefits result from increased physical activity which can conduct to a

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higher reduction of cardiovascular and type 2 diabetes related diseases. The study shows that the estimation of all-cause mortality is a reasonable indicator in health impact assessment. Holm, Glumer, and Diderichsen (2014) estimated the health benefits of increased cycling to work or school levels on both mortality and morbidity in Copenhagen and study found that the potential health gain associated to the 42% share target for cycling was more than a third larger than the potential health loss due to air pollution and traffic accidents. De Hartog, Boogaard, Nijland, and Hoek (2010) estimated the health impacts on allcause mortality generated from increased physical activity of daily urban commuters shifting from car to bicycle in the Netherlands and found that the health benefits of cycling were much larger than the risks relative to car driving (risks of cycling motivated by an higher exposure to air pollution and risk of a traffic accident). Rabl and Nazelle (2012), using specific scenarios (data for Paris and Amsterdam) provided evidence on the health benefits of shifting from car to bicycling or walking, when accounting to four effects
change in exposure to ambient air pollution, the health benefit and the risk of accidents, found that the health benefits (due to increased physical activity) were the most important item. As an example, the health benefits for a car-commuter (5 km one way, 5 days/week and 46 weeks/year) shifting to bicycle were worth 1,310 h/year in a large city (>500,000 inhabitants), much higher than the benefit from the reduction in air pollution (33 h/year) and the average cost of increased accident risk (53 h/year) which also depends on other features of the local context. The authors estimated that the benefits of the system of rental bicycles in Paris (Ve´lib) would be greater than the costs if the system induced a net shift of at least 14,500 car drivers to bicycles (the correspondent health gains would be 52.4 Mh/year in this case). Results from another study conducted amongst cyclists in Stockholm by Borjsesson and Eliasson (2012) are not supportive of health benefits to constitute a major part of social benefits of cycling investments since those effects, were found to be partially internalized. A recent study in Australia commissioned by the Government of Queensland found that health benefits (per kilometre benefits for a typical inner urban project) make up around 80% of the total net benefits associated to both these two active travel modes (QDoT, 2011).

Inclusion of Health Benefits in Active Transport Appraisal The transport appraisal practice reveals that active transport benefits tend to be overlooked and undervalued (Litman, 2013). The current European

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Commission’s transport appraisal guidelines for investment projects do not cover active transport modes (EC, 2008), a gap that seems to contradict the Commission’s proposed ‘Action Plan on Urban Mobility’ that advocates sustainable urban mobility for healthy environments and the link between urban transport and the Trans-European transport network (EC, 2009). So far, only some economic valuation manuals in the World cover non-motorized transport and include recommendations on how to assess the health effects. A few countries in Europe through the Nordic council (Norway, Sweden, Denmark, Finland, Iceland) have carried out the former SCBA studies of transport infrastructures taking into account the health effects (Cavill et al., 2008; WHO, 2011b). Existing CBA studies of walking and cycling infrastructures seem to reveal positive benefit-cost ratios (BCR) when health benefits of active travel are included (Cavill, 2008; Cavill et al., 2008; Genter et al., 2008; Mulley et al., 2013; NCM, 2005; Rutter, 2006; Sælensminde, 2004). In the review by Cavill et al. (2008) the median BCR was 5:1 (in the set of sixteen BCR for various walking/cycling projects, only one was negative) but given the variation in the approaches for including the health effects and other assumptions this figure is indicative. The average values of public health effects found by the Nordic CBA practice were 900 h/year (per active person) and 350 h/year or 0.15 h/cycle.km (per average additional cycling commuter) and the short term absence effects are valued with 2,500 h/year (per employed active person) and 500 h/year (per average additional cycling commuter who becomes active). Mulley et al. (2013) summarizes two main alternative approaches for the estimation of the health benefits: (a) Per ‘new’ active traveller (i.e. it considers only inactive persons who become active as a result of the new walking and cycling infrastructures); (b) Per cyclist or pedestrian kilometre travelled over the period of appraisal. Parallel work in Australia and New Zealand focused on the improvements of walking and cycling economic appraisal frameworks and parameter values (NS PCAL, 2011). For the case of Australia a weighted benefit of $1.68 per km is recommended for walking and a value of $1.12 per km for cycling and these include both mortality and morbidity changes. The New Zealand Transport Agency’s economic valuation manual (NZTA, 2010), addressing the economic efficiency evaluation of demand management and transport services activities for land transport and services, contains specific valuation methods for walking and cycling and include their health benefits. The NZTA manual acknowledges that regular physical activity is associated with improvements in a wide range of health conditions such as heart disease, mental health and diabetes, and includes the health benefits of people that change transport

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modes and become active as a result of the new infrastructure provided (e.g. change from private car to walking or cycling). A health benefit of NZ $2.60 (equivalent to h1.32, assuming 2010 constant prices and the average annual exchange rate) per new pedestrian per km is applied, being the recommended combined benefits’ value for health, safety and road traffic reduction $2.70 (h1.38) for the case of new footpaths and other walking infrastructures. For the case of cycle lanes, cycle ways or increased shoulder widths for cyclists, a health benefit of $1.30 (h 0.66) per new cyclist per km is applied (the recommended combined benefits’ value for health, safety and road traffic reduction is $1.45 (h0.74). The method assumes that people who change mode to active travel do not perceive the wider savings to society (externalities) that resulted from improving health, and that half of the total health benefits are perceived and are internal benefits to cyclists and pedestrians that use the facilities (the calculation of the net benefits for users is based on the known ‘rule of a half’ from economic theory, which says that when consumers change their mode of travel in response to the provision of a new infrastructure, the net consumer surplus averages half of the price changes). Recently, the United Kingdom’s Department of Transport appraisal guidelines started to include specific guidance for the appraisal of walking and cycling investments which includes health benefits from regular physical activity (UKDfT, 2012). The recommended method for estimating the health benefits is based on the WHO HEAT methodology which is said to provide indicative values of the health benefits, as it accounts only to the decreased all-mortality (number of preventable deaths as a result of regular physical activity) but ignores other potential benefits due to reduced morbidity and sickness. There exist several economic approaches to value the health benefits in transport which often comprise the application of willingness-to-pay (WTP) methods to derive the designed value of a statistical life (VSL) which is the WTP to avoid death in relation to the number of years one individual is expected to live considering the statistical life expectancy. Other approaches in the health sector use a common metric by which deaths at different ages and disability can be measured, that is the known Quality-Adjusted-Life Years (QALYs) or Disability-Adjusted Life Years (DALYs) where one DALY represents one lost year of ‘healthy life’. DALY for a disease or injury are estimated as the sum of the years lost due to premature mortality (YLL) in the population, and the years lost due to the disability (YLD) for incident cases of disease or injury. Further details on the calculations of YLL and YLD can be found elsewhere (Matters, Lopez, & Murray, 2006; WHO, 2009).

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The WHO Health Economic Assessment (HEAT) Method The HEAT can be used when planning a new walking or cycling infrastructure and helps decision-makers to identify the most cost-effective investment in terms of health benefits. Simply stated, the HEAT estimates economic savings (from health benefits) using the increase in regular physical activity (from increased walking or cycling volumes) for the population that stands to benefit due to the new infrastructure, and through applying a monetized value of a statistical life (VSL) to the number of avoided premature deaths (that result from reduction of all-cause mortality associated with regular walking), taking into account the relative risk data from published studies and country specific mortality data. HEAT calculates risk reductions as an average across the population under study. The underlying risk data refers to adult populations of 20
74 years (for walking, assuming a moderate pace of 4.8 km/hour) and of 20
64 years old (for cycling). For walking, the relative risk estimate is 0.78 (from the meta-analysis of reviewed studies) which corresponds to an average walking exposure of 29 minutes for 7 days a week at 4.8 km/hour (Baseline volume of walking). As such, the risk data considers that pedestrians whom walk regularly in daily functional trips (e.g. from home to work or school) are 22% less likely to die from any cause than nonregular pedestrians. For cycling, HEAT takes the reference risk value from the Copenhagen Centre for Prospective Population Studies (cohort studies) which found that individuals who regularly cycle 3 hours/week (for 36 weeks of the year) reduce their relative risk of all-cause mortality to 72% in comparison to those whom are not cycle commuters (Andersen, Schnohr, Schroll, & Hein, 2000). Thus, regular cyclists activated by the new infrastructure are assumed to be 28% less likely to die from any cause than non-regular cyclists. The VSL (default value) is h1.574 million per avoided premature death (Nellthorp, Sansom, Bickel, Doll, & Lindberg, 2007). The HEAT assumes a linear dose-response relationship of all-cause mortality reduction and regular levels of active transport. The reduction in all-cause mortality rates (RM) from regular walking is calculated using the default risk data for walking (RR) already mentioned and Eq. (1) (Vol. walking is the volume of observed walking; Baseline is the reference volume of walking): RM = 1 − RRVol: walking=Baseline

ð1Þ

Overall, the economic appraisal in HEAT follows the standard economic theory of social cost-benefit analysis and hence, several economic indicators can be computed: the benefit-cost ratio, the expected annual health benefits and the net present value of the health benefits over the economic period of

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analysis of the walking investment. Further details of the tool can be found in the user guide of the Health Economic Assessment Tools for walking and cycling along its main limitations (WHO, 2011a). The use of HEAT was opportune in the country context as by end of June 2012, the World Health Organization Regional Office for Europe, as part of HEPA Europe/ Healthy Cities sub-network project, contracted the city of Viana do Castelo (with the coordination of the authors) to apply the WHO tool and get information on its usefulness for policy purposes. The next section outlines some results of the case study.

ASSESSING THE HEALTH BENEFITS OF WALKING IN THE CITY OF VIANA DO CASTELO The municipality of Viana do Castelo is located in the North of Portugal in the sub-region of Minho-Lima. It has a total area of 318.6 km2 (40 boroughs) with a resident population in 2011 of 88,725 inhabitants (INE, 2011). The city was founded in the thirteenth century and it is characterized by its regular orthogonal street design, the richness of buildings and diversity of its cultural heritage. The resident population structure can be described as follows: 0
14 years (14%), 15
24 years (11%), 25
64 years (56%) and 65 and more years (20%). The study area (Fig. 1) where HEAT was applied matches almost entirely with the historical centre of the city of Viana do Castelo, integrating two older boroughs designated as ‘Monserrate’ and ‘Santa Maria Maior’, where 18% of the resident population of this municipality lives, and where the age group of 25
64 years also dominates, with a 55% and 56% share, respectively. The modal split share for home-work and home-school trips of residents both in the municipality of Viana do Castelo and in the study area are represented in Table 1. Table 1 shows that car travel has still a high modal share at the municipality and borough levels, a pattern of a car-oriented society. Around 30% of all car trips within the city during weekdays are of less than 30 minutes. Overall, 67% of the trips inside the municipality of Viana do Castelo have a duration of less than 15 minutes and 29% are between 16 and 30 minutes.

Transport, Health and Mobility Policies The key priorities for action for the City of Viana do Castelo (hereafter, referred to as ‘The City’) are defined through its Development Plan for

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Fig. 1. City Investments in Public Space for Pedestrians in the Study Area: ‘A’ Refers to Improvements in the Road Infrastructure and Traffic Management; ‘B’ Refers to a Reconstruction of the Overall Public Space (Streets, Underground Parks, etc.); ‘C’ Refers to Street Reconstruction for Shared Space between Active Transport and Motorized Traffic; ‘D’ Refers to Street Reconstruction Oriented Towards Pedestrians/Complete Ban for Cars.

Health 2007
2015, which aims for a safe and healthy environment and the promotion of sustainable mobility. Based on the health profile of the population, the following seven priorities were set for action: the prevention of cardiovascular disease (the leading cause of death); the promotion of accessibility of disabled people; urban rehabilitation and the environment; health communication; health impact assessment; the integration of migrants; and the promotion of active and healthy ageing. Despite the City’s Cycling Plan, cycling as a daily transport model represents a very insignificant modal share of 1% (Table 1). With regard to walking (improvements in the public space for pedestrians), the City implemented a programme of public investments between 2001 and 2013 comprising several intervention types at the street level (Fig. 1). The cycling network in the City is still incomplete with 9.6 km for future development.

Transport Mode

Resident Population of the Boroughs of Santa Maria Maior and Monserrate (Case Study Area) that Works/Travel to: The same municipality

Walking Car (as driver) Bus Enterprise fleet or school bus Train Motorcycle Bicycle Other Total

Transport Modes for Functional Trips.

2050 2940 107 58 7 25 45 3 5235

39% 56% 2% 1% 0% 0% 1% 0%

The same borough 1598 1145 20 6 1 10 18 1 2799

57% 41% 1% 0% 0% 0% 1% 0%

Another municipality 11 792 22 16 29 1 0 1 872

1% 91% 3% 2% 3% 0% 0% 0%

Resident Population of the Municipality of Viana do Castelo that Works/Travel to: The same municipality 4604 20529 1122 791 92 459 284 48 27929

16% 74% 4% 3% 0% 2% 1% 0%

The same borough 3742 4440 88 109 3 135 140 31 8688

43% 51% 1% 1% 0% 2% 2% 0%

Another municipality 41 4282 112 269 116 34 7 16 4877

1% 88% 2% 6% 2% 1% 0% 0%

The Economic Assessment of Health Benefits of Active Transport

Table 1.

Data Source: INE (2011).

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Data Collection and Analysis The HEAT was used to estimate the health economic benefits obtained from street reconstruction projects in the historic centre of the city. As such, we aimed to collect data for HEAT on the average volume of pedestrians (and cyclists) in the study area (that could benefit from the mentioned street reconstruction projects) and the average time people spend in regular walking and cycling activities (inputs for HEAT). As such, a specific mobility survey was developed and implemented in the study area with the support of the City technical team, along with pedestrian traffic counts. Complementarily, several barriers were identified by respondents which according to their perceptions were responsible for them not pursuing walking or cycling. The sample size was statistically representative of the city (with a 5% margin of error; 95% of confidence level) and the spatial distribution of surveys is represented in Fig. 2. A total of 337 valid surveys were achieved: 55% of the respondents were females and 45% males; the adult age group of 20
64 years represents 68% of the sample (share of the adult group of 20
74 years is 76.7%), and hence, the sample features fitted the requirements for applying HEAT. The analysis of mobility data from respondents shows that regular functional trips are dominant in the study area: 61.8% of respondents walk regularly for home to work purposes and 26.9% walk regularly for home to school purposes. Only 7% of the inquired population said not to perform regular walking in the city. The trip duration profiles for those who stated to walk regularly were: