Infrastructure policy and public health: Evidence from OECD countries

When making infrastructure policies, decision makers insufficiently consider negative consequences for the environment or health. This lack of multi-sectorial awareness in policymaking triggers poor public health outcomes. To illustrate this issue, this interdisciplinary work presents evidence for the association of road infrastructure investment (as infrastructure policy) with the incidences of deaths due to transport accidents, chronic obstructive pulmonary disease, and pneumonia using nationally aggregated data from the Organisation for Economic Co-operation and Development for 27 countries over an 18-year period (1995-2012). We conduct an explorative analysis using descriptive statistics and fixed-effects panel-data regression models that include the interaction of the policy variable with the Environmental Policy Stringency Index, which proxies the awareness of negative consequences of policies. We show that countries which never achieved a score of 3 or higher for the Environmental Policy Stringency Index had higher levels of standardized death rates. This is supported by Pearson's correlation coefficients and by the results of t-tests for deaths due to transport accidents. Following the fixed-effects analysis, we find that an increase in road infrastructure investment of 1% of gross domestic product is associated, on average, with about three additional deaths per 100,000 population due to transport accidents and about 18 fewer deaths per 100,000 population due to chronic obstructive pulmonary disease using standardized death rates. A one unit increase in the Environmental Policy Stringency Index is related to about 7 fewer deaths per 100,000 population due to chronic obstructive pulmonary diseases. Marginal effects of the interaction of road infrastructure investment and the Environmental Policy Stringency Index are significant for standardized death rates due to transport accidents and chronic obstructive pulmonary disease. Multi-sectorial awareness in infrastructure policy mediates health effects for deaths due to transport accidents and chronic obstructive pulmonary disease.