Background Road safety progress in Canada is hindered by the cost associated with Vision Zero (VZ) policies, and whether cost and related (life-saving) benefits associated with VZ implementation can be rationalized by the varying levels of government. There are few studies on the cost of transport injury in Canada. The present study investigated the cost of transport injuries in Canada to provide more context around VZ investment.

Objective To describe the health care and societal costs of transport injury in Canada, including the loss of productivity and society’s willingness to make investments in the prevention of transport deaths.

Methods Societal and health system costs were calculated by applying 2018 data, using the Electronic Resource Allocation Tool (ERAT), a spreadsheet-based injury classification and costing model which can be applied at various jurisdictional levels depending on data quality and availability. The costing method is based on a societal, or population, perspective, using an incidence and human costing approach. Direct costs of deaths, hospitalizations, emergency department visits and disabilities were calculated. These costs included the lifetime medical costs of injuries and the cost of caring for those with long-term disability. Indirect costs or lifetime productivity losses due to injuries were calculated. Indirect costs included the time spent by caregivers in doing unpaid household activities as well as the additional cost that individuals would be willing to pay for improvements in health and safety.

Results The total cost of transport injuries in Canada was estimated at $4.4 billion in 2018. Direct health care costs totalled $2.3 billion and indirect costs totalled $2.1 billion. A separate estimation for value of statistical life (VSL) calculated a cost of $17.1 billion. Motor vehicle occupants experienced the highest VSL at $6.8 billion, as well as the highest societal costs at $2.3 billion and per capita cost of $62 per person in Canada.

Conclusions The present study highlights the cost of transport injury in Canada and supports the investment in VZ policies. Although many Canadian cities have adopted the VZ approach, continued investment is needed to help more communities in Canada and beyond reduce the cost of transport injury.