== 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.

​

Document type: Article

​

== Full document ==

<pdf>Media:Draft_Content_114076425-beopen2887-1838-document.pdf</pdf>

​

​

== Original document ==

​

The different versions of the original document can be found in:

​

* [http://dx.doi.org/10.3390/ijerph110808010 http://dx.doi.org/10.3390/ijerph110808010] under the license https://creativecommons.org/licenses/by

​

* [http://europepmc.org/articles/PMC4143846 http://europepmc.org/articles/PMC4143846] under the license http://creativecommons.org/licenses/by/3.0/

​

* [http://nrs.harvard.edu/urn-3:HUL.InstRepos:12329273 http://nrs.harvard.edu/urn-3:HUL.InstRepos:12329273]

​

* [http://nrs.harvard.edu/urn-3:HUL.InstRepos:12785830 http://nrs.harvard.edu/urn-3:HUL.InstRepos:12785830]

​

* [https://dx.doi.org/10.3390/ijerph110808010 https://dx.doi.org/10.3390/ijerph110808010]

​

* [https://www.mdpi.com/1660-4601/11/8/8010/pdf https://www.mdpi.com/1660-4601/11/8/8010/pdf]

​

* [http://www.mdpi.com/1660-4601/11/8/8010 http://www.mdpi.com/1660-4601/11/8/8010],

: [https://doaj.org/toc/1660-4601 https://doaj.org/toc/1660-4601] under the license cc-by

​

* [http://www.mdpi.com/1660-4601/11/8/8010/pdf http://www.mdpi.com/1660-4601/11/8/8010/pdf],

: [http://dx.doi.org/10.3390/ijerph110808010 http://dx.doi.org/10.3390/ijerph110808010]

​

* [https://www.mdpi.com/1660-4601/11/8/8010 https://www.mdpi.com/1660-4601/11/8/8010],

: [http://dash.harvard.edu/bitstream/handle/1/12785830/4143846.pdf?sequence=1 http://dash.harvard.edu/bitstream/handle/1/12785830/4143846.pdf?sequence=1],

: [https://www.mdpi.com/1660-4601/11/8/8010/pdf https://www.mdpi.com/1660-4601/11/8/8010/pdf],

: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4143846 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4143846],

: [http://www.tphlink.com/uploads/1/1/4/0/11401949/boston_transit_fare_increases_and_hia.pdf http://www.tphlink.com/uploads/1/1/4/0/11401949/boston_transit_fare_increases_and_hia.pdf],

: [https://dash.harvard.edu/handle/1/12785830?show=full https://dash.harvard.edu/handle/1/12785830?show=full],

: [http://europepmc.org/articles/PMC4143846 http://europepmc.org/articles/PMC4143846],

: [http://core.ac.uk/display/26677904 http://core.ac.uk/display/26677904],

: [http://nrs.harvard.edu/urn-3:HUL.InstRepos:12329273 http://nrs.harvard.edu/urn-3:HUL.InstRepos:12329273],

: [https://doaj.org/article/6223cc4047894f5e9bf10e39586617f5 https://doaj.org/article/6223cc4047894f5e9bf10e39586617f5],

: [https://www.researchgate.net/profile/Peter_James11/publication/264629817_A_Health_Impact_Assessment_of_Proposed_Public_Transportation_Service_Cuts_and_Fare_Increases_in_Boston_Massachusetts_(U.S.A.)/links/53eb9d170cf250c89479d123.pdf https://www.researchgate.net/profile/Peter_James11/publication/264629817_A_Health_Impact_Assessment_of_Proposed_Public_Transportation_Service_Cuts_and_Fare_Increases_in_Boston_Massachusetts_(U.S.A.)/links/53eb9d170cf250c89479d123.pdf],

: [https://core.ac.uk/display/26677904 https://core.ac.uk/display/26677904],

: [https://academic.microsoft.com/#/detail/2106114436 https://academic.microsoft.com/#/detail/2106114436] under the license https://creativecommons.org/licenses/by/4.0/

​

* [ ]

​

​

​

​

​

DOIS: 10.3390/ijerph110808010 10.3390/ijerph110808010.

​