Astrid Ledgaard Holm HIA International Conference Granada 14 th of April 2011

1. Department of Public Health Health Impact Assessment of CommutingA quantitative analysis of changes in burden of disease due to increased commuting by bicycle in and out of Copenhagen Astrid Ledgaard Holm HIA International Conference Granada 14th of April 2011

2. Department of Public Health Context of the study • 37% of everyone working or studying in Copenhagen choose to go by bike • By 2015 Copenhagen aims to: • Increase the percentage of commuters that cycle to work or education in Copenhagen to 50% • Reduce by 50 % the number of seriously injured cyclists

3. Department of Public Health Purpose of the study • Dual purpose: • Estimate the health effect of increased commuting by bicycle in and out of Copenhagen • Shift commuters from passive to active transport • Both positive and negative effects • Health Impact Assessment as a decision making tool in Danish municipalities • Increasing interest in HIA in Denmark • Focus on quantification in effect estimation

4. Department of Public Health Methods used in the study Policy, project or programme Screening Scoping Effect analysis Reporting Monitoring and evaluation

5. Department of Public Health Screening Policy, project or programme Screening tool Screening Is it relevant to perform an HIA? Scoping Effect analysis Reporting Monitoring and evaluation

6. Department of Public Health Scoping (1) Policy, project or programme Quantitative approach (Burden of Disease) Screening Selection of relevant determinants of health Scoping Effect analysis Selection of relevant health outcomes Reporting Monitoring and evaluation

7. Department of Public Health Scoping (2) Increased commuting by bicycle Project or plan Physical inactivity Air pollution Health determinants Bicycle accidents Changed incidence of ischemic hearth disease, ischemic stroke, type II diabetes, breast and colon cancer Health outcomes Changed burden of disease in the population of commuters Aggregated effect

8. Department of Public Health Effect analysis Policy, project or programme Policy analysis and baseline description Impact assessment Screening Estimation of effect on health determinants Outcome assessment Scoping Assessment of effect on health outcomes Effect analysis Aggregation Assessment of aggregated effect on health outcomes Reporting Monitoring and evaluation Interpretation and formulation of recommendations

9. Department of Public Health Main results of effect analysis • Analyses of different scenarios • 50% bicycle commuting: • Reduction of 17 DALY (1,3%) • 50% bicycle commuting + no increase in number of bicycle accidents: • Reduction of 54 DALY (4,1%) • 50% bicycle commuting + no increase in number of accidents + shift of physically inactive commuters: • Reduction of 151 DALY (11,4%) • Very limited effect of air pollution

10. Department of Public Health Reporting Policy, project or programme Screening Scoping Effect analysis Report and disseminate knowledge of results and recommendations Reporting Monitoring and evaluation

11. Department of Public Health Conclusion and recommendations • Shifting commuters to go by bicycle has potential to lower the burden of disease in the population • Conditions for achieving positive health impacts of bicycle commuting: • Reduce effect of bicycle accidents • Reduce number and severity of accidents • Achieve maximum change in exposure • Shift physically inactive commuters

12. Department of Public Health Thank you for your attention