Mortality Implications of Increased Active Mobility for a Proposed Regional Transportation Emission Cap-and-Invest Program.

The transportation sector is now the primary contributor to greenhouse gas emissions in the USA. The Transportation Climate Initiative (TCI), a partnership of 12 states and the District of Columbia currently under development, would implement a cap-and-invest program to reduce transportation sector emissions across the Northeast and Mid-Atlantic region, including substantial investment in cycling and pedestrian infrastructure. Using outputs from an investment scenario model and the World Health Organization Health Economic Assessment Tool methodology, we estimate the mortality implications of increased active mobility and their monetized value for three different investment allocation scenarios considered by TCI policymakers. We conduct these analyses for all 378 counties in the TCI region. We find that even for the scenario with the smallest investment in active mobility, when it is fully implemented, TCI would result in hundreds of fewer deaths per year across the region, with monetized benefits in the billions of dollars annually. Under all scenarios considered, the monetized benefits from deaths avoided substantially exceed the direct infrastructure costs of investment. We conclude that investing proceeds in active mobility infrastructure is a cost-effective way of reducing mortality, especially in urban areas, providing a strong motivation for investment in modernization of the transportation system and further evidence of the health co-benefits of climate action.