Aging infrastructure creates opportunities for cost-efficient restoration of aquatic ecosystem connectivity.

A hallmark of industrialization is the construction of dams for water management and roads for transportation, leading to fragmentation of aquatic ecosystems. Many nations are striving to address both maintenance backlogs and mitigation of environmental impacts as their infrastructure ages. Here, we test whether accounting for road repair needs could offer opportunities to boost conservation efficiency by piggybacking connectivity restoration projects on infrastructure maintenance. Using optimization models to align fish passage restoration sites with likely road repair priorities, we find potential increases in conservation return-on-investment ranging from 17% to 25%. Importantly, these gains occur without compromising infrastructure or conservation priorities; simply communicating openly about objectives and candidate sites enables greater accomplishment at current funding levels. Society embraces both reliable roads and thriving fisheries, so overcoming this coordination challenge should be feasible. Given deferred maintenance crises for many types of infrastructure, there could be widespread opportunities to enhance the cost effectiveness of conservation investments by coordinating with infrastructure renewal efforts.

A method for the inclusion of physical activity-related health benefits in cost-benefit analysis of built environment initiatives.

The built environment has a significant influence on population levels of physical activity (PA) and therefore health. However, PA-related health benefits are seldom considered in transport and urban planning (i.e. built environment interventions) cost-benefit analysis. Cost-benefit analysis implies that the benefits of any initiative are valued in monetary terms to make them commensurable with costs. This leads to the need for monetised values of the health benefits of PA. The aim of this study was to explore a method for the incorporation of monetised PA-related health benefits in cost-benefit analysis of built environment interventions. Firstly, we estimated the change in population level of PA attributable to a change in the built environment due to the intervention. Then, changes in population levels of PA were translated into monetary values. For the first step we used estimates from the literature for the association of built environment features with physical activity outcomes. For the second step we used the multi-cohort proportional multi-state life table model to predict changes in health-adjusted life years and health care costs as a function of changes in PA. Finally, we monetised health-adjusted life years using the value of a statistical life year. Future research could adapt these methods to assess the health and economic impacts of specific urban development scenarios by working in collaboration with urban planners.

When I'm 84: What Should Life Look Like in Old Age?

Housing and the built environment are well-established social determinants of healthy longevity, yet no guidelines or standards exist for the design and construction of health-promoting environments, especially for older adults who are at risk for functional decline and frailty. To envision what should be included in the design of healthy communities, it may help to reverse-engineer what each of us would like our lives to look like in old age. In this special article, a geriatrician draws on his own personal aspirations and successful models of supportive community-based programs to suggest key factors that should be considered in the design of future living environments. These include healthy housing that can enable aging in place without social isolation and loneliness; engagement in meaningful and productive work; financial, physical, transportation, food, and housing security; and affordable high-quality home- and community-based healthcare. By conceptualizing what we would like our later years to look like, future leaders can be more deliberate in creating living environments that promote a long and productive health span. J Am Geriatr Soc 68:967-969, 2020.

Can the use of road safety measures on national roads in Norway be interpreted as an informal application of the ALARP principle?

The ALARP principle, stating that risks should be reduced to a level "As Low As Reasonably Practicable", is widely known and discussed in risk management. The principle is flexible, as the interpretation of the key concepts of reasonable and practicable can be adapted to different contexts. This paper discusses whether the use of road safety measures on national roads in Norway can be interpreted as an informal application of the ALARP-principle. According to official guidelines, priority setting for major road investments should be based on cost-benefit analysis. Most road safety measures are low-cost projects that have traditionally not been subject to cost-benefit analysis. A use of these measures regarded as reasonable in the ALARP sense may include considerations of cost, efficiency and fair distribution. Data on 328 road safety measures implemented around 2000 is used to evaluate factors influencing their use. It is argued that the use of these measures is consistent with an informal application of the ALARP-principle.

Looking for traces of the Troika's intervention in European road safety.

The recent economic crisis has required the bailout of some European States by the so-called Troika, with capital injections accompanied by financial austerity. This paper analyzes econometrically the impact of this support programme on road safety for an original panel data (1995-2015). The findings also corroborate the Kuznets curve hypothesis for traffic accidents in the long term. Regarding the impact of intervention in the short term, despite reductions in safety policy budgets due to austerity, financial support, and related austerity measures might have led to an improvement in road safety, reducing both the number of accidents and fatalities. Therefore, it seems that our result is more linked to the austerity measures than to the financial support given by the Troika.

Interregional inequality and road accident rates in Spain.

The aim of this study was to determine whether interregional inequality in Spain had the same impact on the risks of fatality and injury across the different provinces of Spain, in the period from 1999 to 2015. This allows us to map fatality and injury rates in Spanish provinces depending on their level of economic development. Provinces were divided in two large groups according to the mean weight of their per capita GDP on the national GDP from 2000 to 2015. Using fixed effects data panel models, estimations were obtained for each group of the impact of the relationships between per capita GDP, unemployment rate and other control variables on their risks of fatality and injury. The models reveal that economic conditions and education are explanatory factors with greater significance and impact on the risks of fatality and injury in provinces with higher levels of economic development. In this group, the penalty-points driving licence was found have a greater impact, although its effectiveness is now being questioned. In contrast, to reduce the risks of fatality and injury in less developed provinces, it is imperative to invest in road infrastructure, increasing the proportion of high capacity roads and investing more in road replacement and maintenance. The geographical distribution generated in this study allows us to better identify the areas with a higher risk of fatality or injury. This, in turn, confirms the need to improve the configuration of road safety policy, taking into account the different fatality or injury rates across provinces, the origins of which lie in the specific provincial conditions.

Contribution analysis to analyze the effects of the health impact assessment at the local level: A case of urban revitalization.

The health impact assessment (HIA) is a tool used to estimate the potential impact on health of non-health-related proposals prior to implementation. While it is increasingly used in Quebec, Canada, studies have not analyzed its medium-term impacts and potential long-term impacts. We conducted a contribution analysis using in-depth interviews with key stakeholders, as well as documents, observation and images related to HIA in order to analyze its impacts on the revitalization of road infrastructure, parks and green spaces, and residential housing. Our analysis not only reflects on the decision-making process through the adoption and implementation of HIA recommendations, but also on the link between actions implemented in the field and health outcomes.

A systematic cost-benefit analysis of 29 road safety measures.

Economic evaluations of road safety measures are only rarely published in the scholarly literature. We collected and (re-)analyzed evidence in order to conduct cost-benefit analyses (CBAs) for 29 road safety measures. The information on crash costs was based on data from a survey in European countries. We applied a systematic procedure including corrections for inflation and Purchasing Power Parity in order to express all the monetary information in the same units (EUR, 2015). Cost-benefit analyses were done for measures with favorable estimated effects on road safety and for which relevant information on costs could be found. Results were assessed in terms of benefit-to-cost ratios and net present value. In order to account for some uncertainties, we carried out sensitivity analyses based on varying assumptions for costs of measures and measure effectiveness. Moreover we defined some combinations used as best case and worst case scenarios. In the best estimate scenario, 25 measures turn out to be cost-effective. 4 measures (road lighting, automatic barriers installation, area wide traffic calming and mandatory eyesight tests) are not cost-effective according to this scenario. In total, 14 measures remain cost-effective throughout all scenarios, whereas 10 other measures switch from cost-effective in the best case scenario to not cost-effective in the worst case scenario. For three measures insufficient information is available to calculate all scenarios. Two measures (automatic barriers installation and area wide traffic calming) even in the best case do not become cost-effective. Inherent uncertainties tend to be present in the underlying data on costs of measures, effects and target groups. Results of CBAs are not necessarily generally valid or directly transferable to other settings.

Prioritizing highway safety improvement projects: A Monte-Carlo based Data Envelopment Analysis approach.

Road authorities have to prioritize safety improvement projects due to budget limitations. This process needs to estimate expected benefits (reduction in average crash frequency) and costs of projects. Due to variances of crash modification factor (CMF), crash frequency and cost of projects, prediction of costs and benefits would be accompanied by uncertainty and it can subsequently lead to a wrong decision making. To deal with the inherent uncertainty in the decision making process, this paper presents a ranking approach based on integration of Data Envelopment Analysis and Monte-Carlo simulation. A Monte-Carlo simulation is applied to generate stochastic values as input and outputs of the problem instead of running DEA model just for deterministic case. Data from an existing case study is used to evaluate the performance of the proposed methodology. Numerical results indicate that DEA results are very sensitive to data uncertainty and uncertainties can have great influence in ranking results of road safety improvement projects especially when both input and output data are uncertain. It also indicates that how the proposed methodology can be useful for detecting sensitive decision-making units and providing a more comprehensive view for decision makers to allocate a limit budget to the most efficient safety improvement projects.

Precision medicine and healthy living: The importance of the built environment.

The built environment encompasses the major physical spaces, including buildings, streets, homes, schools, parks, playgrounds and other infrastructure in which we live, work and play. In an ideal world, the built environment should support and facilitate a healthy engagement in physical activity across the lifespan. However, in the context of an environment characterized by increased mechanization and urbanization, physical inactivity and higher levels of overweight and obesity, too many settings are not conducive to physical activity and/or are not safe and walkable. In the knowledge that there are multiple challenges to redress the low levels of physical activity seen in many parts of the world, this paper provides some examples of opportunities for healthy living (HL) in a built environment characteristic of an increasingly urbanized world. Particular foci include opportunities for HL fostered in child-friendly cities, in which walkability is high, and active transport is encouraged and supported.

Exploring and visualizing the small-area-level socioeconomic factors, alcohol availability and built environment influences of alcohol expenditure for the City of Toronto: a spatial analysis approach. / Explorer et visualiser à échelle fine les facteurs socioéconomiques, l'accès aux boissons alcoolisées et l'incidence de l'environnement bâti sur les dépenses en alcool dans la ville de Toronto : démarche d'analyse spatiale.

INTRODUCTION: Many Canadians continue to drink alcohol in excess of the recommended low-risk guidelines. In this study, we visualized the geographic variation of licensed premises alcohol expenditures in Toronto and examined the effects of area-level socioeconomic characteristics, alcohol availability and built environment influences on alcohol expenditures at the Dissemination Area (DA) level. METHODS: Dissemination Area average total household expenditures on alcohol from licensed premises, from the 2010 Survey of Household Spending, was the main outcome variable. Moran's I and Local Moran's I were used to quantify geographic variation and determine hot spots and cold spots of expenditure. We used DA-level socioeconomic characteristics from the 2006 Census of Canada, and the density of licensed premises and other built environment characteristics from the 2008 DMTI Spatial and 2010 CanMap datasets to predict alcohol expenditures in multivariate spatial regression models. RESULTS: The results indicated that the most significant area-level predictors of alcohol expenditure were the percentage of individuals in management or finance occupations and the percentage with postsecondary education (one-unit increases associated with 78.6% and 35.0% increases in expenditures respectively). Presence of subway lines in the immediate and neighbouring areas was also significant (one-unit increases resulted in 5% and 28% increases respectively). Alcohol outlet density was also positively associated with alcohol expenditures. CONCLUSION: The associations identified between licensed premises alcohol expenditures and small-area-level characteristics highlight the potential importance of small-area-level factors in understanding alcohol use. Understanding the small-area-level characteristics of expenditures and geographic variation of alcohol expenditures may provide avenues for alcohol use reduction initiatives and policies.

INTRODUCTION: De nombreux Canadiens continuent de boire beaucoup plus d'alcool que ce que préconisent les Directives de consommation d'alcool à faible risque. Dans cette étude, nous avons illustré les variations spatiales associées aux dépenses engagées dans des établissements licenciés à Toronto et nous avons examiné les effets des facteurs socioéconomiques locaux, de l'accès aux boissons alcoolisées et de l'incidence de l'environnement bâti sur les dépenses en alcool à l'échelle des aires de diffusion (AD). MÉTHODOLOGIE: D'après l'Enquête sur les dépenses des ménages de 2010, ce sont les dépenses totales moyennes des ménages à l'échelle des AD en boissons alcoolisées achetées dans des établissements licenciés qui sont la variable ayant la plus grande incidence sur les résultats. L'indice de Moran et l'indice local de Moran ont été utilisés pour quantifier les variations spatiales et pour identifier les points chauds et les points froids en termes de dépenses. Nous avons utilisé, dans divers modèles multidimensionnels de régression spatiale, les caractéristiques socioéconomiques à l'échelle des AD tirées du Recensement de 2006 ainsi que des ensembles de données de 2008 de DMTI Spatial et de 2010 de CanMap concernant la densité des établissements licenciés et les autres caractéristiques socioéconomiques de l'environnement bâti afin de prédire les dépenses en alcool. RÉSULTATS: Les principaux indicateurs à échelle fine associés aux dépenses en alcool étaient le pourcentage de personnes occupant des postes dans les domaines de la gestion ou des finances ainsi que le pourcentage de personnes ayant une éducation post-secondaire (une augmentation d'une unité étant associée à des augmentations respectives de l'ordre de 78,6 % et de 35,0 % des dépenses). La présence de lignes de métro dans l'environnement immédiat et dans le quartier constituait aussi un facteur important (une augmentation d'une unité entraînant des hausses de l'ordre de respectivement 5 % et 28 % des dépenses). La densité des points de vente d'alcool constituait également un facteur positif sur les dépenses en alcool. CONCLUSION: Les liens entre les dépenses en alcool engagées dans des établissements licenciés et les caractéristiques des zones à échelle fine mettent en lumière l'importance que pourraient jouer les facteurs à cette échelle dans notre compréhension de la consommation d'alcool. Bien comprendre les caractéristiques des unités géographiques à échelle fine et les variations spatiales en matière de dépenses en alcool pourrait offrir des outils pour les politiques et initiatives de réduction de la consommation d'alcool.

Energy savings, emission reductions, and health co-benefits of the green building movement.

Buildings consume nearly 40% of primary energy production globally. Certified green buildings substantially reduce energy consumption on a per square foot basis and they also focus on indoor environmental quality. However, the co-benefits to health through reductions in energy and concomitant reductions in air pollution have not been examined.We calculated year by year LEED (Leadership in Energy and Environmental Design) certification rates in six countries (the United States, China, India, Brazil, Germany, and Turkey) and then used data from the Green Building Information Gateway (GBIG) to estimate energy savings in each country each year. Of the green building rating schemes, LEED accounts for 32% of green-certified floor space and publically reports energy efficiency data. We employed Harvard's Co-BE Calculator to determine pollutant emissions reductions by country accounting for transient energy mixes and baseline energy use intensities. Co-BE applies the social cost of carbon and the social cost of atmospheric release to translate these reductions into health benefits. Based on modeled energy use, LEED-certified buildings saved $7.5B in energy costs and averted 33MT of CO2, 51 kt of SO2, 38 kt of NOx, and 10 kt of PM2.5 from entering the atmosphere, which amounts to $5.8B (lower limit = $2.3B, upper limit = $9.1B) in climate and health co-benefits from 2000 to 2016 in the six countries investigated. The U.S. health benefits derive from avoiding an estimated 172-405 premature deaths, 171 hospital admissions, 11,000 asthma exacerbations, 54,000 respiratory symptoms, 21,000 lost days of work, and 16,000 lost days of school. Because the climate and health benefits are nearly equivalent to the energy savings for green buildings in the United States, and up to 10 times higher in developing countries, they provide an important and previously unquantified societal value. Future analyses should consider these co-benefits when weighing policy decisions around energy-efficient buildings.