Cost Effectiveness of a Bicycle/Pedestrian Trail Development in Health Promotion
This study found that three-quarters of trail users in Lincoln, Nebraska report being more physically active since they began using trails, most of whom are active for general health. The cost per user who is more active since they began using the trails is $98, less than other programs aimed at increasing physical activity.
This study’s findings are of interest to those who want to describe how trails are related to increased physical activity in a community. However, other cost-effectiveness studies (see 47) employ a more careful measure of trail users. The authors assume the number of users they counted on a single summer weekend day represent all unique trail users for the year, which is likely a significant understatement of annual trail usage. Additionally, trail costs are estimated without accounting for land acquisition, leading to very low cost estimates. With low estimates of use and cost, it is difficult to determine whether the cost-effectiveness ratios are particularly low or high.
The study is based in Lincoln, Nebraska, population 259,218 in 2013.
The study included data from four trails, three paved and one gravel, ranging from 3.1 to 4.6 miles long. All trails are multi-use and used predominantly by walkers and cyclists.
The purpose of this study is to estimate how cost-effectively trails increase physical activity in a community, with the goal of comparing the findings to other actions aimed at increasing physical activity. This study was conducted by researchers at the Centers for Disease Control and Prevention and the Nebraska Health and Human Services System.
- Seventy-one percent of respondents stated the trail increased the number of times they are physically active each week.
- Seventy-four percent of respondents stated they were generally more physically active since using the trail.
- Fifty-one percent of respondents stated they were active for general health, 17 percent for “enjoyment and to feel better,” 11 percent for personal fitness, and 8 percent for weight loss.
- The trail cost $98 for each user who is more physically active.
- The trail cost $142 for each user who is active for general health.
- The trail cost $884 for each user who is active for weight loss.
The authors generated trail use estimates using in-person counters on a single Sunday in summer. It is not clear whether they accounted for round-trip users. The authors counted 3,986 users across all trails.
On two separate days, 378 completed interviews were obtained from users on the trail. The response rate was not reported. The authors measure changes in physical activity in three ways: 1) the number of users more active since they began using the trails, 2) the number of users who were active for general health, and 3) the number of users who were active for weight loss. They apply the means and proportions from these survey responses to all users counted on the trail.
The authors obtained data on cost from a local trail census and the trail managing agency. Assuming a 30-year lifespan for the trails, they calculated annualized costs.
The authors calculated cost-effectiveness ratios by dividing the trail cost by the number of trail users for that day.
Wang, G., C. Macera, B. Scudder-Soucie, T. Schmid, M. Pratt, and D. Buchner. 2004. “Cost effectiveness of a bicycle/pedestrian trail development in health promotion.” Preventive Medicine 38(2): 237-242.