“Health in All Policies” in Practice: Guidance and Tools to Quantifying the Health Effects of Cycling and Walking

in Journal of Physical Activity and Health


There is growing interest in “Health in All Policies” approaches, aiming at promoting health through policies which are under the control of nonhealth sectors. While economic appraisal is an established practice in transport planning, health effects are rarely taken into account. An international project was carried out to develop guidance and tools for practitioners for quantifying the health effects of cycling and walking, supporting their full appraisal.

Development Process:

A systematic review of existing approaches was carried out. Then, the products were developed with an international expert panel through an extensive consensus finding process.

Products and Applications:

Methodological guidance was developed which addresses the main challenges practitioners encounter in the quantification of health effects from cycling and walking. A “Health Economic Assessment Tool (HEAT) for cycling” was developed which is being used in several countries.


There is a need for a more consistent approach to the quantification of health benefits from cycling and walking. This project is providing guidance and an illustrative tool for cycling for practical application. Results show that substantial savings can be expected. Such tools illustrate the importance of considering health in transport policy and infrastructure planning, putting “Health in All Policies” into practice.

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Kahlmeier and Racioppi are with the European Centre for Environment and Health, World Health Organization (WHO), Regional Office for Europe, Rome, Italy. Cavill is with Cavill Associates, Stockport, United Kingdom. Rutter is with the National Obesity Observatory, Oxford, United Kingdom. Oja is with the UKK Institute for Health Promotion Research, Tampere, Finland.

Journal of Physical Activity and Health