Journal
ENVIRONMENT INTERNATIONAL
Volume 108, Issue -, Pages 22-31Publisher
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.envint.2017.07.009
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Funding
- Sao Paulo Research Foundation [2012/08565-4, 2013/25624-7]
- National Council for Scientific and Technological Development [200358/2014-6, 402648/2015-3]
- British Heart Foundation
- Cancer Research UK
- Economic and Social Research Council
- Medical Research Council
- National Institute for Health Research (NIHR)
- Wellcome Trust
- UK Clinical Research Collaboration
- NIHR postdoctoral Fellowship
- Economic and Social Research Council [ES/G007462/1] Funding Source: researchfish
- Medical Research Council [MR/P024408/1, MR/K023187/1, MR/K021796/1] Funding Source: researchfish
- ESRC [ES/G007462/1] Funding Source: UKRI
- MRC [MR/K021796/1, MR/K023187/1, MR/P024408/1] Funding Source: UKRI
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Background: Sao Paulo city, Brazil, faces challenges caused by rapid urbanization. We illustrate how future travel patterns could lead to different health consequences in the city. Methods: We evaluated the health impacts of different travel pattern scenarios for the Sao Paulo adult population by comparing the travel patterns of Sao Paulo in 2012 with counterfactual scenarios in which the city adopted travel patterns of i) those living in the city's expanded centre; ii) London (2012); iii) a highly motorized Sao Paulo (SP California); and iv) a visionary Sao Paulo (SP 2040), with high levels of walking and cycling and low levels of car and motorcycle use. For each scenario we estimated changes in exposure to air pollution, road injury risk, and physical activity. Health outcomes were estimated using disability adjusted life years (DALYs) and premature deaths averted. Sensitivity analyses were performed to identify the main sources of uncertainty. Results: We found considerable health gains in the SP 2040 scenario (total 63.6 k DALYs avoided), with 4.7% of premature deaths from ischemic heart disease avoided from increases in physical activity alone. Conversely, we found substantial health losses in the scenario favouring private transport (SP California, total increase of 54.9 k DALYs), with an increase in road traffic deaths and injuries among pedestrians and motorized vehicles. Parameters related to air pollution had the largest impact on uncertainty. Conclusions: Shifting travel patterns towards more sustainable transport can provide major health benefits in Sao Paulo. Reducing the uncertainties in the findings should be a priority for empirical and modelling research on the health impacts of such shifts.
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