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Int. J. Environ. Res. Public Health 2014, 11(8), 8010-8024; doi:10.3390/ijerph110808010

A Health Impact Assessment of Proposed Public Transportation Service Cuts and Fare Increases in Boston, Massachusetts (U.S.A.)

1
Departments of Epidemiology and Environmental Health, Harvard School of Public Health, 401 Park Drive, Boston, MA 02215, USA
2
Metropolitan Area Planning Council, 60 Temple Place, Boston, MA 02111, USA
3
Harvard Center for Health and the Global Environment, 401 Park Drive, Boston, MA 02215, USA
4
Boston University School of Public Health, 715 Albany St. Talbot Building, Boston, MA 02118, USA
5
Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA 02138, USA
*
Author to whom correspondence should be addressed.
Received: 9 June 2014 / Revised: 17 July 2014 / Accepted: 21 July 2014 / Published: 7 August 2014
(This article belongs to the Special Issue Health Impact Assessment: Realizing Its Potential)
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Abstract

Transportation decisions have health consequences that are often not incorporated into policy-making processes. Health Impact Assessment (HIA) is a process that can be used to evaluate health effects of transportation policy. We present a rapid HIA, conducted over eight weeks, evaluating health and economic effects of proposed fare increases and service cuts to Boston, Massachusetts’ public transportation system. We used transportation modeling in concert with tools allowing for quantification and monetization of multiple pathways. We estimated health and economic costs of proposed public transportation system changes to be hundreds of millions of dollars per year, exceeding the budget gap the public transportation authority was required to close. Significant health pathways included crashes, air pollution, and physical activity. The HIA enabled stakeholders to advocate for more modest fare increases and service cuts, which were eventually adopted by decision makers. This HIA was among the first to quantify and monetize multiple pathways linking transportation decisions with health and economic outcomes, using approaches that could be applied in different settings. Including health costs in transportation decisions can lead to policy choices with both economic and public health benefits. View Full-Text
Keywords: Health Impact Assessment; public transportation; air pollution; physical activity; crashes; monetization Health Impact Assessment; public transportation; air pollution; physical activity; crashes; monetization
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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MDPI and ACS Style

James, P.; Ito, K.; Buonocore, J.J.; Levy, J.I.; Arcaya, M.C. A Health Impact Assessment of Proposed Public Transportation Service Cuts and Fare Increases in Boston, Massachusetts (U.S.A.). Int. J. Environ. Res. Public Health 2014, 11, 8010-8024.

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