“Public Health is Return on Investment: Save Lives, Save Money.”

That is the theme for this year’s National Public Health Week, April 1-7, and the American Public Health Association (APHA) is asking us all to put a spotlight on the “return on investment” to staying healthy. APHA focuses on transportation policy for one of their daily themes this week, stating: “Together, we can turn our streets into roads to better health.” Unfortunately, new data the NYS Department of Health shows that New York State’s current transportation policy is in fact bad public health policy.

Between 2008 and 2010 in downstate New York, pedestrian and cycling injuries resulting from motor vehicle crashes cost over $500 million in immediate medical bills, a number that only includes emergency room visits and hospitalizations. The mean charge per visit to the emergency room was $2,104 for pedestrians, and $2,372 for cyclists; if the victim needed to be hospitalized, the costs jumped substantially—$48,112 per hospitalization for pedestrians and $36,039 for bicyclists. The mean number of victims treated each year was just over 15,000.

Half a billion is a big number, but it does not include a whole host of other public health costs. The costs of those who actually died (about 240 people each year in downstate New York) are not included. Nor are the costs of rehabilitation, lost mobility, emotional duress or long-term disability. There are also non-health related costs: lost work productivity, family impacts and legal fees. These costs are the “externalities” of a transportation policy that is heavily weighted towards moving cars, and not one that incorporates safe infrastructure for all users of our state’s roadways.

While the New York State Department of Transportation currently tracks injuries and fatalities related to motor vehicles, cross-referencing that data with related medical expenses would bring us one step closer to understanding the true rate of return on our investments. What would be the rate of return, from a public health and safety point of view, for a $1 million investment in sidewalks in a busy downtown versus a $1 million investment in a highway project? How much would the state save on Medicaid and Medicare and saved lives if New York City were to implement a speed camera demonstration program that could stop some of the carnage? These types of calculations are rarely made, and currently New York does not spend a fair share for the safety of vulnerable users of our transportation system.

New York’s FY13 federal Transportation Alternatives funding, which will pay for pedestrian and bicycle improvements in New York State,  is $28 million. Imagine the savings that could be generated if this investment was even half of the $500 million it cost to treat injured pedestrians and cyclists between 2008-2010 in downstate New York alone.