NYC study shows that bicycle lanes are 'exceptionally good value' because they address multiple public health problems

A new study, The cost-effectiveness of bike lanes in New York City, has determined that investments in bicycle lanes come with an exceptionally good value because they simultaneously address multiple public health problems, and are more cost-effective than the majority of preventive approaches used today. Results from this study showed that New York City’s bike lanes deliver a 'QALY' for just $ 1300 (a QALY is a “quality-adjusted life year”, or “the equivalent of on additional year of life at full health"). That’s more expensive than the most cost-effective investment, vaccines (at just $100 per QALY) but a lot better than direct health treatments like dialysis, at $129,000 per QALY. 

Study co-author Dr. Babak Mohit of the Mailman School of Public Health at Columbia University told Kathryn Doyle of Reuters: ‘For bike lanes the cost per QALY is $1,300, a little bit higher than vaccines but way lower than most medical interventions that we have in healthcare. We’re finding more and more of these social interventions are not directly medically related but have an extremely positive effect on giving us more life years…I definitely think there’s room for expansion of bike lanes, the city spends $67,000 per QALY for Medicaid and we think spending $1,300 per QALY buys you a lot more life for a lot less money.

The study abstract outlines its aims and objectives: to evaluate the cost-effectiveness of investments in bike lanes using New York City's (NYC) fiscal year 2015 investment as a case study. 

The study team also provides a generalizable model, so that localities can estimate their return on bike lane investments.

In methods and findings, the team ‘evaluates the cost-effectiveness of bike lane construction using a two-stage model. Our regression analysis, to estimate the marginal addition of lane miles on the expansion in bike ridership, reveals that the 45.5 miles of bike lanes NYC constructed in 2015 at a cost of $8 109 511.47 may increase the probability of riding bikes by 9.32%. 

‘In the second stage, we constructed a Markov model to estimate the cost-effectiveness of bike lane construction. This model compares the status quo with the 2015 investment. We consider the reduced risk of injury and increased probability of ridership, costs associated with bike lane implementation and maintenance, and effectiveness due to physical activity and reduced pollution. 

‘We use Monte Carlo simulation and one-way sensitivity analysis to test the reliability of the base-case result. This model reveals that over the lifetime of all people in NYC, bike lane construction produces additional costs of $2.79 and gain of 0.0022 quality-adjusted life years (QALYs) per person. This results in an incremental cost-effectiveness ratio of $1297/QALY gained (95% CI −$544/QALY gained to $5038/QALY gained).

The team concluded that investments in bicycle lanes come with an exceptionally good value because they simultaneously address multiple public health problems. Investments in bike lanes are more cost-effective than the majority of preventive approaches used today.