Related Experiment Video
Updated: Nov 25, 2025

Using a Virtual Reality Walking Simulator to Investigate Pedestrian Behavior
Published on: June 9, 2020
Economics of Interventions to Increase Active Travel to School: A Community Guide Systematic Review
Verughese Jacob1, Sajal K Chattopadhyay1, Jeffrey A Reynolds1
1Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia.
Context:
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.
Evidence Acquisition:
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.
Evidence Synthesis:
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.
Conclusions:
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.
Related Concept Videos
Study Designs in Epidemiology
Observational studies are those where the researcher does not intervene but rather observes natural variations. They include cross-sectional, cohort, and...
Community Based Intervention
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
Models of Health Promotion and Illness Prevention II
The agent-host-environment model states that disease results...
Models of Health Promotion and Illness Prevention I
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
Levels of Health Promotion and Illness Prevention
In primary prevention, actions taken before disease onset prevent the disease from...
Bias in Epidemiological Studies

