Background Neighbourhood slow zones (NSZs) are areas that attempt to slow traffic via speed limits coupled with other measures (eg, speed humps). They appear to reduce traffic crashes and encourage active transportation. We evaluate the cost-effectiveness of NSZs in New York City (NYC), which implemented them in 2011.
Methods We examined the effectiveness of NSZs in NYC using data from the city’s Department of Transportation in an interrupted time series analysis. We then conducted a cost-effectiveness analysis using a Markov model. One-way sensitivity analyses and Monte Carlo analyses were conducted to test error in the model.
Results After 2011, road casualties in NYC fell by 8.74% (95% CI 1.02% to 16.47%) in the NSZs but increased by 0.31% (95% CI −3.64% to 4.27%) in the control neighbourhoods. Because injury costs outweigh intervention costs, NSZs resulted in a net savings of US$15 (95% credible interval: US$2 to US$43) and a gain of 0.002 of a quality-adjusted life year (QALY, 95% credible interval: 0.001 to 0.006) over the lifetime of the average NSZ resident relative to no intervention. Based on the results of Monte Carlo analyses, there was a 97.7% chance that the NSZs fall under US$50 000 per QALY gained.
Conclusion While additional causal models are needed, NSZs appeared to be an effective and cost-effective means of reducing road casualties. Our models also suggest that NSZs may save more money than they cost.
- neighbourhood slow zones
- traffic injury
- New York City
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Contributors BJ: substantial contributions to the conception or design of the work, analysis or interpretation of data for the work and drafting the work and revising it critically for important intellectual content; SK: substantial contributions to interpretation of data for the work and drafting the work; JH: substantial contributions to the conception or design of the work and revising it critically for important intellectual content; PAM: substantial contributions to the conception or design of the work and drafting the work and revising it critically for important intellectual content. All authors: final approval of the version to be published.
Funding This study was funded by Global Research Analytics for Population Health at the Mailman School of Health, Columbia University. All the authors have approved the final manuscript for submission.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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